Meghan B Brunnock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

000967 Issued in CT

Practice address

34 Water Street
Suite 2
Mystic, CT 06355

Phone

(860) 572-9994

Fax

(860) 572-9930

NPI assigned

Oct 10, 2006

Last updated

Aug 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Physician Assistant

Education

Duke University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John R. West MD IncGroup PAC ID 5092719484, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007

Merit-based Incentive Payment System (MIPS)

Final score

91.31 of 100Reported as individual

Quality

82.62

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• John R. West MD Inc

  dba Seaport Dermatology

  • MOHS-Micrographic Surgery Physician
  • Mystic, CT
  • NPI 1376575324
  Medicare reassignment Care Compare group
• Eric R. Wolf, M.D., P.C.

  • Dermatology Physician
  • Groton, CT
  • NPI 1447459672
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459
  Care Compare affiliation

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1063500841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WATER STREET",
            "address_2": "SUITE 2",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-9994",
            "fax_number": "860-572-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WATER STREET",
            "address_2": "SUITE 2",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-9994",
            "fax_number": "860-572-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNOCK",
        "first_name": "MEGHAN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Jean Boulay
• Tiffany Bradley
• Howard Brensilver, M.D.
• Barbara Jean Bronson, ED.D.
• Daniel Stubbs Brown, LCSW
• Linda M Brustolon, LPTA
• Kim Michelle Bucko, OTR
• Leah Bueneman, PA-C
• Stephanie Buske
• Tess Marie Cagenello

• Physician Assistant in Mystic, CT
• Providers in Mystic, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.

Verify at the official NPI Registry.