Thomas E Bruderly, DO

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

34-00-6379 Issued in OH

Practice address

395 E Market St
Akron, OH 44304-1542

Phone

(330) 762-8959

Fax

(330) 762-1224

NPI assigned

Jan 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Montgomery Ear Nose & Throat Clinic Inc

  • Otolaryngology/Facial Plastic Surgery Physician
  • Cincinnati, OH
  • NPI 1326001363
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1164493896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 HARVARD RD",
            "address_2": "2ND FLOOR",
            "city": "HIGHLAND HILLS",
            "state": "OH",
            "postal_code": "441227251",
            "telephone_number": "216-358-2315",
            "fax_number": "216-201-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 E MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041542",
            "telephone_number": "330-762-8959",
            "fax_number": "330-762-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDERLY",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OH",
            "license": "34-00-6379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0258500",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomasbruderly@uhps.allscrptsdirect.net",
            "affiliation": "N",
            "address_1": "395 E Market St",
            "city": "Akron",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443041542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomasbruderly@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "395 E Market St",
            "city": "Akron",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443041542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Marie Browning
• Lacie Marie Brubaker, LPCC
• Lilia Brubaker, LPCC
• Mary E Bruce, PA
• Curtis Lee Bruckelmyer
• John Mitchell Bruketa, ATC, AT
• Jessica Brumbaugh
• Chelise Brumfield
• Andrea Brumley, CT
• Laura Susan Bruneau, PC

• Otolaryngology/Facial Plastic Surgery Physician in Akron, OH
• Providers in Akron, OH by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.