Timothy Peter Bruce, M.D.
Individual provider Active NPI Plastic Surgery Physician · Glendale, WI
NPI 1013228907 · NPPES record last updated Sep 1, 2022
Key facts
- NPI
- 1013228907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Plastic Surgery Physician 208200000X
- License
- 80034-20 (WI)
- Practice address
- 6002 N Port Washington Rd
Glendale, WI 53217-4524 - Phone
- (414) 439-3000
- NPI assigned
- Jun 25, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Plastic and Reconstructive Surgery
- Education
- Medical College of Wisconsin, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- CJ Hussussian MD SC
Practice addresses (Care Compare)
N4W22370 Bluemound Rd
Suite 100
Waukesha, WI 53186-1683
Phone (262) 970-5600
Hospital & facility affiliations
- Waukesha Memorial Hospital
- Ascension Columbia St Marys Hospital Milwaukee
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220906002976 | WI | Practitioner - Plastic and Reconstructive Surgery | 7315239902 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01070075A | IN | MD | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician |
| 125.068486 | IL | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CJ Hussussian MD SC | Plastic Surgery | Current |
Accepting new patients |
Locations
19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000
6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100
2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932
N4W22370 Bluemound Rd
Ste 100
Waukesha, WI 53186
Phone (262) 970-5600
N4W22370 Bluemound Rd
Waukesha, WI 53186
Phone (262) 970-5600
725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011
8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000
Interoperability endpoints
- tbruce159599@direct.phci.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Undersea and Hyperbaric Medicine (Emergency Medicine) Physician | 207PE0005X | 01070075A | IN | |
| Plastic Surgery Physician | 208200000X | 125.068486 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Plastic Surgery Physician | 208200000X | 80034-20 | WI | Yes |
Addresses
Primary practice location
6002 N Port Washington Rd
Glendale, WI 53217-4524
Mailing address
N4W22370 Bluemound Rd
Waukesha, WI 53186-1683
Phone (414) 439-3000
Other practice location 1
N4W22370 Bluemound Rd
Waukesha, WI 53186-1683
Phone (414) 439-3000
Other providers in Glendale, WI
- Brown Deer Dental Health Center, SC
- Bradley Kyle Brown
- Danicha S Brown
- Bruce Holmstrom D.D.S.,SC
- Ted Terry Bruce
- Jay Bubrick
- Lauri Rachelle Budzynski
- Judith E Bulluck
- Rachel Cable
- James E Cain Jr.
All providers in Glendale, WI · Plastic Surgery Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.