Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lillie Demarest Bullock

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1285304600

Lillie Demarest Bullock is a Physician Assistant in Anchorage, Alaska. Qualified in 2022, 4 years ago. Practices with Alaska Native Tribal Health Consortium, a 603-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
4
Licensed in
AK
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone: (907) 729-3300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Medex Northwest, Seattle, WA 98105 — (206) 616-4001

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (AK)

Record details

NPI number1285304600
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 16, 2021
Last updated in NPPESMarch 9, 2023
Certification dateMarch 9, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Alaska Native Tribal Health Consortium — 603 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Anchorage