NPIMap

Individual provider Active NPI

Melissa Marie Bruner, PA-C

  • Medical Physician Assistant
  • New Port Richey, FL
National Provider Identifier
1194834291
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9100790 Issued in FL
Practice address
6804 Cecelia Drive
New Port Richey, FL 34653-4935
Phone
(855) 232-0644
Fax
(888) 546-0488
NPI assigned
Aug 30, 2006
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9100790 FL Primary

Addresses

Primary practice location

6804 Cecelia Drive
New Port Richey, FL 34653-4935

Mailing address

6804 Cecelia Drive
New Port Richey, FL 34653-4935
Phone (855) 232-0644

Other names 1

  • Ms. Melissa Marie Thiele Professional name

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9100790FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Palms of Pasadena Emergency Physicians LLC Past Accepting new patients
Russell Emergency Physicians LLC Past Accepting new patients
Tarpon Springs Emergency Physicians, LLC Past Accepting new patients
Town & Country Emergency Physicians LLC Past Accepting new patients
Sunshine City Emergency Physicians Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients
Franklin, Favata & Hulls, MD's, PA Past Accepting new patients
Sunbeam Point Emergency Physicians LLC Past Accepting new patients
Emergency Physician Specialists Inc Past Accepting new patients

Organizations & group practices 9

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1194834291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DRIVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DRIVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9100790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "THIELE",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.