Active NPI
Bruce Hayse, M. D.
- General Practice Physician
- Jackson, WY
National Provider Identifier
1154491579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 3433A
- Practice address
- 269 West Broadway
Jackson, WY 83001-1884 - Phone
- (307) 733-6700
- Fax
- (307) 739-8890
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 3433A | WY | Primary |
Addresses
Primary practice location
269 West Broadway
Jackson, WY 83001-1884
Mailing address
PO Box 1884
Jackson, WY 83001-1884
Phone (307) 733-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 302273 | Other | WY | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100120000769 | WY | Practitioner - General Practice | 3274675806 | Practice locations: Jackson, WY |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Oregon Health Sciences University School of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
269 W Broadway Ave
Jackson, WY 83001-8635
Phone (307) 733-6700
PO Box
Suite 1884
Jackson, WY 83001-1884
Hospital & facility affiliations
- St John'S Home Care
- St Johns Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 22.19 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 73.96
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 24 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Ownership & related parties
All facility ownership & control disclosures 5
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| St Johns Med Center/Or St Johns Health | Hospital | Corporate Director (14.28%) | Nov 1, 2008 |
| St Johns Medical Center | Hospital | Corporate Director (14.28%) | Nov 3, 2008 |
| St Johns Health Sage Living | Skilled nursing facility | Operational/Managerial Control Trustee of the SNF Adp of the SNF |
Nov 5, 2008 Nov 5, 2008 Nov 5, 2008 |
| St. John'S Home Care | Home health agency | Corporate Director (14.28%) | Nov 6, 2008 |
| St. John'S Hospice | Hospice | Corporate Director (14.28%) | Jul 19, 2012 |
Owned or controlled facilities with NPI records 4
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- Jackson, WY
- NPI 1215064985
Adp of the SNF, Operational/Managerial Control, Trustee of the SNF
-
- Community Based Hospice Care Agency
- Jackson, WY
- NPI 1568493989
Corporate Director
-
- General Acute Care Hospital
- Jackson, WY
- NPI 1801835475
Corporate Director
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Jackson, WY
- NPI 1194744235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154491579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1884",
"city": "JACKSON",
"state": "WY",
"postal_code": "830011884",
"telephone_number": "307-733-6700",
"fax_number": "307-739-8890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269 WEST BROADWAY",
"city": "JACKSON",
"state": "WY",
"postal_code": "830011884",
"telephone_number": "307-733-6700",
"fax_number": "307-739-8890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYSE",
"first_name": "BRUCE",
"credential": "M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WY",
"license": "3433A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "302273",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.