Kelly Bultman
NPI 1104491414ActiveIndividual· Physician Assistant· Beavercreek, OH
Physician Assistant in Beavercreek, Ohio, licensed in OH, with an NPI issued in May 2021. Part D covered 174 prescriptions written in 2024, 98% of them generic. Grifols USA, LLC reported $16.61 in payments in 2024, mostly food and beverage.
Overview
| NPI | 1104491414 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | May 20, 2021 |
| Last updated in NPPES | Jul 22, 2022 |
| Certified by provider | Jul 22, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 50.006573RX | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OH) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 174 · 175 30-day fills |
|---|---|
| Patients | 109 |
| Total drug cost | $1,170 |
| Generic share | 98% of claims |
Industry payments (Open Payments)
- 2024$16.61 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Grifols USA, LLC | $16.61 | 1 |
What the 2024 payments were for
- Food and Beverage$16.61 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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