Individual provider Active NPI

Matthew Bruno, P.A.

  • Physician Assistant
  • Peru, IL
National Provider Identifier
1104854066
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001822 Issued in IL
Practice address
925 West St
Peru, IL 61354-2757
Phone
(815) 221-1384
NPI assigned
Jun 29, 2006
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001822 IL Primary

Addresses

Primary practice location

925 West St
Peru, IL 61354-2757

Mailing address

925 West St
Peru, IL 61354-2757
Phone (815) 221-1384

Other practice location 1

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 999-3275

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbruno379182@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20041221000926 IL Practitioner - Physician Assistant 4981662046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.91 of 100Reported as group
Quality
96.37
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085001822ILMDPhysician Assistant

Organizations & group practices 2

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1104854066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 WEST ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542757",
            "telephone_number": "815-221-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 WEST ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542757",
            "telephone_number": "815-221-1384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Glenwood Ave",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604355487",
            "country_code": "US",
            "telephone_number": "815-999-3275",
            "fax_number": "815-741-6293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "MATTHEW",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbruno379182@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2100 Glenwood Ave",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604355487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

Verify at the official NPI Registry.