Mr Travis L Bullock, MD - Medicare Urology in Saint Louis, MO

Mr Travis L Bullock, MD is a medicare enrolled "Urology" physician in Saint Louis, Missouri. He went to Eastern Virginia Medical School and graduated in 2002 and has 22 years of diverse experience with area of expertise as Urology. He is a member of the group practice Urology Of St. Louis, Inc, Urology Of St. Louis, Inc and his current practice location is 12855 N 40 Dr Ste 350, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at (314) 567-6071.

Mr Travis L Bullock is licensed to practice in Missouri (license number 2007030776) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1699810507.

Contact Information

Mr Travis L Bullock, MD
12855 N 40 Dr Ste 350,
Saint Louis, MO 63141-8669
(314) 567-6071
(314) 567-3321



Physician's Profile

Full NameMr Travis L Bullock
GenderMale
SpecialityUrology
Experience22 Years
Location12855 N 40 Dr Ste 350, Saint Louis, Missouri
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Travis L Bullock attended and graduated from Eastern Virginia Medical School in 2002
  NPI Data:
  • NPI Number: 1699810507
  • Provider Enumeration Date: 02/20/2007
  • Last Update Date: 04/06/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8325144272
  • Enrollment ID: I20080115000058

Medical Identifiers

Medical identifiers for Mr Travis L Bullock such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1699810507NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology 2007030776 (Missouri)Primary
208800000XUrology 036113441 (Illinois)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Anderson HospitalMaryville, ILHospital
Hshs St Elizabeth's HospitalO fallon, ILHospital
Missouri Baptist Medical CenterTown and country, MOHospital
Memorial HospitalBelleville, ILHospital
St Joseph's HospitalHighland, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Urology Of St. Louis, Inc620472378658
Urology Of St. Louis, Inc620472378658

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Travis L Bullock allows following entities to bill medicare on his behalf.
Entity NameUrology Of St. Louis, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528017191
PECOS PAC ID: 6204723786
Enrollment ID: O20050502001141

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Entity NameHeartland Rural Healthcare Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275166134
PECOS PAC ID: 3072513043
Enrollment ID: O20061226000075

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Entity NameOsf Multi-specialty Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922445527
PECOS PAC ID: 3678889789
Enrollment ID: O20150904000279

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Entity NameAhs Il Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659098101
PECOS PAC ID: 5496111676
Enrollment ID: O20230512001300

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Travis L Bullock is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Travis L Bullock, MD
12855 N. Forty Dr., Ste 375,
St. Louis, MO 63141

Ph: (314) 567-6071
Mr Travis L Bullock, MD
12855 N 40 Dr Ste 350,
Saint Louis, MO 63141-8669

Ph: (314) 567-6071

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Urology Doctors in Saint Louis, MO

Dr. Charles Phillips Jones, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 4921 Parkview Pl, Div Surg Urology, Ste 11c, Saint Louis, MO 63110
Phone: 314-362-8200    Fax: 314-454-5244
Dr. Carl G Klutke, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1040 N Mason Rd, Ste 122, Saint Louis, MO 63141
Phone: 314-996-8060    Fax: 314-747-4871
Dr. Nitai C Saha, M.D.
Urology
Medicare: Not Enrolled in Medicare
Practice Location: 533 Couch Ave, Suite 174, Saint Louis, MO 63122
Phone: 314-822-1413    Fax: 314-822-1859
Michael James Glamore, M.D.
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110
Phone: 314-362-5000    
Dr. James Kelly, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 3915 Watson Rd Ste 203, Saint Louis, MO 63109
Phone: 314-771-5822    Fax: 314-771-5827
Maung Htein Thu, M.D
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 12700 Southfork Rd Ste 260, Saint Louis, MO 63128
Phone: 314-543-5270    
Dr. Zeynep Gul, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 4921 Parkview Pl, Div Surg Urology, Ste 11c, Saint Louis, MO 63110
Phone: 314-362-8200    Fax: 314-454-5244

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