NPIMap

Individual provider Active NPI

Maria Fe Fiel Bruce, MD

  • Family Medicine Physician
  • Joplin, MO
National Provider Identifier
1124136718
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2007028405 Issued in MO
Practice address
3126 S Jackson Ave
Suite 201
Joplin, MO 64804-2534
Phone
(417) 781-4727
Fax
(417) 627-8727
NPI assigned
Aug 25, 2006
Last updated
Feb 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036109260 IL
Family Medicine Physician 207Q00000X 2007028405 MO Primary

Addresses

Primary practice location

3126 S Jackson Ave
Suite 201
Joplin, MO 64804-2534

Mailing address

3126 S Jackson Ave
Suite 201
Joplin, MO 64804-2534
Phone (417) 781-4727

Other names 1

  • Maria Fe Fiel Detalla Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071105000071 MO Practitioner - Family Practice 6800790775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

202 E 50TH St
MC Family Medicine 50TH Street
Joplin, MO 64804-4527
Phone (417) 556-3400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036109260ILMDFamily Medicine Physician
2007028405MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC Family Medicine CurrentSince Nov 1, 2009 Accepting new patients
Sjmgroup Past Accepting new patients
Graham Services Corporation Family Medicine Past Accepting new patients

Locations

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1717 S Range Line Rd
Ste B
Joplin, MO 64804
Phone (417) 556-2231

202 E 50th St
Joplin, MO 64804
Phone (417) 556-3400

3126 S Jackson Ave
Joplin, MO 64804
Phone (417) 782-1600

3126 S Jackson Ave
Ste 201
Joplin, MO 64804
Phone (417) 556-2830

Interoperability endpoints

  • Direct secure messaging: mbruce190699@directb.mercy.net
  • Direct secure messaging: mbruce200156@directc.mercy.net

Organizations & group practices 3

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 12

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1124136718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 S JACKSON AVE",
            "address_2": "SUITE 201",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042534",
            "telephone_number": "417-781-4727",
            "fax_number": "417-627-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3126 S JACKSON AVE",
            "address_2": "SUITE 201",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042534",
            "telephone_number": "417-781-4727",
            "fax_number": "417-627-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "MARIA FE",
        "middle_name": "FIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036109260",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2007028405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA FE",
            "last_name": "DETALLA",
            "middle_name": "FIEL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.