Active NPI
Bayley Marie Brunck, OD
- Optometrist
- Bloomington, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18004177A
- Practice address
- 1105 S College Mall Rd
Bloomington, IN 47401-6177 - Phone
- (812) 333-2020
- Fax
- (812) 334-2020
- NPI assigned
- Jul 9, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18004177A | IN | Primary |
Addresses
Primary practice location
1105 S College Mall Rd
Bloomington, IN 47401-6177
Mailing address
1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200728000150 | IN | Practitioner - Optometry | 8921422635 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Myeyedr Optometry of Indiana LLC
Practice addresses (Care Compare)
1105 S College Mall Rd
Bloomington, IN 47401-6177
Phone (812) 333-2020
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18004177A | IN | MD | Optometrist |
Practice roles (3 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Indiana, LLC | Optometrist | Current | Accepting new patients |
Locations
1105 S College Mall Rd
Bloomington, IN 47401
Phone (812) 333-2020
9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200
357 W Morgan St
Ste C
Spencer, IN 47460
Phone (812) 829-1254
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Networks
- KY PPO
- KY PPO C-SNP
Organizations & group practices 11
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Indianapolis, IN
- NPI 1093201485
-
- Optometrist
- Indianapolis, IN
- NPI 1356900195
-
- Optometrist
- Terre Haute, IN
- NPI 1588150908
-
- Optometrist
- Valparaiso, IN
- NPI 1669931846
-
- Optometrist
- Fishers, IN
- NPI 1699261024
-
- Optometrist
- Anderson, IN
- NPI 1710473194
-
- Optometrist
- Fort Wayne, IN
- NPI 1962998393
-
- Optometrist
- Michigan City, IN
- NPI 1982190328
-
- Optometrist
- Bloomington, IN
- NPI 1568936698
-
- Optometrist
- Munster, IN
- NPI 1922974526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635379200000",
"number": "1013569243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 OLD GALLOWS RD STE 520",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823970",
"telephone_number": "703-847-8899",
"fax_number": "571-223-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 S COLLEGE MALL RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474016177",
"telephone_number": "812-333-2020",
"fax_number": "812-334-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNCK",
"first_name": "BAYLEY",
"middle_name": "MARIE",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-09",
"last_updated": "2021-10-28",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "IN",
"license": "18004177A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.