Individual provider Active NPI

Thomas A Brugnoli, O.D.

  • Optometrist
  • Morgantown, WV
National Provider Identifier
1114157328
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1086-OD Issued in WV
Practice address
499 High St
Morgantown, WV 26505-5516
Phone
(304) 296-2540
Fax
(304) 296-2542
NPI assigned
Jul 22, 2009
Last updated
Jan 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1086-OD WV Primary

Addresses

Primary practice location

499 High St
Morgantown, WV 26505-5516

Mailing address

499 High St
Morgantown, WV 26505-5516
Phone (304) 296-2540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1086-ODWVMDOptometrist

Organizations & group practices 1

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": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1114157328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 HIGH ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055516",
            "telephone_number": "304-296-2540",
            "fax_number": "304-296-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 HIGH ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055516",
            "telephone_number": "304-296-2540",
            "fax_number": "304-296-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUGNOLI",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "1086-OD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.