Individual provider Active NPI

Bradley P Bruns, PA

  • Medical Physician Assistant
  • Middletown, OH
National Provider Identifier
1053365957
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50001078 Issued in OH
Practice address
2408 Hill Ave
Middletown, OH 45044-4732
Phone
(513) 569-6780
Fax
(859) 372-0065
NPI assigned
May 22, 2006
Last updated
Aug 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50001078 OH Primary

Addresses

Primary practice location

2408 Hill Ave
Middletown, OH 45044-4732

Mailing address

PO Box 427
Florence, KY 41022-0427
Phone (513) 569-6780

Other identifiers 1

IdentifierTypeStateIssuer
P00644116OtherOHRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050916000546 OH Practitioner - Physician Assistant 2163455460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.63 of 100Reported as group
Quality
95
Improvement activities
40
Cost
68.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50001078OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seniors First Inc. Medical Past Accepting new patients
Trihealth Physician Institute Past Accepting new patients
Trihealth Physician Institute Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1053365957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 427",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410220427",
            "telephone_number": "513-569-6780",
            "fax_number": "859-372-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 HILL AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450444732",
            "telephone_number": "513-569-6780",
            "fax_number": "859-372-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "BRADLEY",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50001078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00644116",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.