Kelly Bultman, - Medicare Physician Assistant in Beavercreek, OH

Kelly Bultman, is a medicare enrolled "Physician Assistant" in Beavercreek, Ohio. Her current practice location is 2510 Commons Blvd Ste 210, Beavercreek, Ohio. You can reach out to her office (for appointments etc.) via phone at (513) 833-4912.

Kelly Bultman is licensed to practice in Ohio (license number 50.006573RX) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104491414.

Contact Information

Kelly Bultman,
2510 Commons Blvd Ste 210,
Beavercreek, OH 45431-3821
(513) 833-4912
Not Available



Provider's Profile

Full NameKelly Bultman
GenderFemale
SpecialityPhysician Assistant
Location2510 Commons Blvd Ste 210, Beavercreek, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104491414
  • Provider Enumeration Date: 05/20/2021
  • Last Update Date: 07/22/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 1658734082
  • Enrollment ID: I20230831003288

Medical Identifiers

Medical identifiers for Kelly Bultman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104491414NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 50.006573RX (Ohio)Primary

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. Kelly Bultman 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
Kelly Bultman,
2510 Commons Blvd Ste 210,
Beavercreek, OH 45431-3821

Ph: (513) 833-4912
Kelly Bultman,
2510 Commons Blvd Ste 210,
Beavercreek, OH 45431-3821

Ph: (513) 833-4912

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Physician Assistant Nurses in Beavercreek, OH

Amanda Yun Anania, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3535 Pentagon Blvd Ste 330, Beavercreek, OH 45431
Phone: 937-757-9449    Fax: 937-702-4944
Lindsey R Hammett, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 111 Harbert Dr, Beavercreek, OH 45440
Phone: 937-208-7575    Fax: 937-208-7590
Emily Grace Trompak (o'neal), PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3535 Pentagon Blvd, Beavercreek, OH 45431
Phone: 937-702-4450    Fax: 937-702-4459
Sarah Gould, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 2510 Commons Blvd Ste 210, Beavercreek, OH 45431
Phone: 937-429-0607    Fax: 937-429-0608
Breanne Henderson, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 42 Woodcroft Trl, Beavercreek, OH 45430
Phone: 937-429-0682    
Michelle A Ortman, P.A.-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 75 Sylvania Dr, Beavercreek, OH 45440
Phone: 937-320-5050    Fax: 937-320-5060

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