Marissa Leonore Bruno, DO
Individual provider Active NPI Family Medicine Physician · Prineville, OR
NPI 1073262986 · NPPES record last updated Oct 1, 2025
Key facts
- NPI
- 1073262986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DO224540 (OR)
- Practice address
- 384 SE Combs Flat Rd
Prineville, OR 97754-2562 - Phone
- (541) 447-6263
- Fax
- (541) 447-8724
- NPI assigned
- Mar 20, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Charles Health System Inc
Practice addresses (Care Compare)
384 SE Combs Flat Rd
Prineville, OR 97754-2562
Phone (541) 706-2768
Hospital & facility affiliations
- St Charles Medical Center Prineville
- St Charles Medical Center - Bend
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- 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 |
|---|---|---|---|---|
| I20250814002860 | OR | Practitioner - Family Practice | 3476937459 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Charles Health System, Inc. | Family Medicine | Current |
Accepting new patients |
| St. Charles Health System, Inc. | Current |
Accepting new patients | |
| St. Charles Health System, Inc. | Current |
Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current |
Accepting new patients |
Locations
29358 Network Pl
Chicago, IL 60673
61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930
384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668
384 SE Combs Flat Rd
Ste 1200
Prineville, OR 97754
Phone (541) 447-6263
1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131
211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164
Interoperability endpoints
- mbruno186392@secure.stcharleshealthcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | DO224540 | OR | Yes |
Addresses
Primary practice location
384 SE Combs Flat Rd
Prineville, OR 97754-2562
Mailing address
384 SE Combs Flat Rd
Prineville, OR 97754-2562
Phone (541) 447-6254
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbruno186392@secure.stcharleshealthcare.org |
Other providers in Prineville, OR
- Shannon K Brasher
- Kathryn Broadaway
- Mary Katherine Brook
- Jenna Danielle Brown
- Christopher Brubaker
- Stephanie Bueckert
- Diana M Burden
- Donna Buring
- Carissa Bussard
- Elbert Lee Butler III
All providers in Prineville, OR · Family Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2025. 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.