Individual provider Active NPI

Bruce Mackellar, MD

  • Family Medicine Physician
  • Canaseraga, NY
National Provider Identifier
1093769358
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
176089 Issued in NY
Practice address
12 N Church St
Canaseraga, NY 14822-9721
Phone
(607) 545-2111
Fax
(607) 545-2100
NPI assigned
May 20, 2006
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 176089 NY Primary

Addresses

Primary practice location

12 N Church St
Canaseraga, NY 14822-9721

Mailing address

10869 State Route 36
Dansville, NY 14437-9444
Phone (585) 335-3100

Other identifiers 1

IdentifierTypeStateIssuer
01254388MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091013000473 NY Practitioner - Family Practice 1456497056 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12 N Church St
Canaseraga, NY 14822-9721
Phone (607) 545-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Tri-County Family Medicine Program, Inc. CurrentSince Sep 15, 2025 Accepting new patients
Rochester General Hospital CurrentSince Mar 1, 2020 Accepting new patients
Rochester General Hospital Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Tri-County Family Medicine Program, Inc. Family Medicine CurrentSince Sep 15, 2025 Accepting new patients
St James Hospital Past Accepting new patients

Locations

10869 State Route 36
Dansville, NY 14437
Phone (585) 335-3100

111 Clara Barton St
Dansville, NY 14437
Phone (585) 335-3100

60 Red Jacket St
Ste 1
Dansville, NY 14437
Phone (585) 335-6041

111 Loder St
#A
Hornell, NY 14843
Phone (607) 324-5404

411 Canisteo St
Hornell, NY 14843
Phone (607) 324-8000

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1093769358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10869 STATE ROUTE 36",
            "city": "DANSVILLE",
            "state": "NY",
            "postal_code": "144379444",
            "telephone_number": "585-335-3100",
            "fax_number": "585-335-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N CHURCH ST",
            "city": "CANASERAGA",
            "state": "NY",
            "postal_code": "148229721",
            "telephone_number": "607-545-2111",
            "fax_number": "607-545-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKELLAR",
        "first_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "176089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01254388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canaseraga, NY

Sources for this page

Verify at the official NPI Registry.