Active NPI
Mikael Laursen Brucker, LAC, ND
- Acupuncturist
- Elkins Park, PA
National Provider Identifier
1003384926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AK001281
- Practice address
- 710 Meetinghouse Rd
Elkins Park, PA 19027 - Phone
- (215) 919-1166
- NPI assigned
- Nov 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 099.0134073 | VT | |
| Acupuncturist | 171100000X | AK001281 | PA | Primary |
Addresses
Primary practice location
710 Meetinghouse Rd
Elkins Park, PA 19027
Mailing address
710 Meetinghouse Rd
Elkins Park, PA 19027-1417
Phone (215) 919-1166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AK001281 | PA | MD | Acupuncturist |
| 099.0134073 | VT | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541635200000",
"number": "1003384926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 MEETINGHOUSE RD",
"city": "ELKINS PARK",
"state": "PA",
"postal_code": "190271417",
"telephone_number": "215-919-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 MEETINGHOUSE RD",
"city": "ELKINS PARK",
"state": "PA",
"postal_code": "19027",
"telephone_number": "215-919-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCKER",
"first_name": "MIKAEL",
"middle_name": "LAURSEN",
"name_prefix": "Dr.",
"credential": "LAC, ND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-08",
"last_updated": "2018-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "VT",
"license": "099.0134073",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "PA",
"license": "AK001281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkins Park, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.