Individual provider Active NPI

Bruce Bradley Cleeremans, MD

  • Neurology Physician
  • Irvine, CA
National Provider Identifier
1205042249
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G046938 Issued in CA
Practice address
16405 Sand Canyon Ave Ste 220
Irvine, CA 92618-3787
Phone
(949) 753-1882
Fax
(949) 727-3365
NPI assigned
May 15, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G046938 CA Primary

Addresses

Primary practice location

16405 Sand Canyon Ave Ste 220
Irvine, CA 92618-3787

Mailing address

16405 Sand Canyon Ave Ste 220
Irvine, CA 92618-3787
Phone (949) 753-1882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040210000816 CA Practitioner - Neurology 2163316266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Minnesota Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16405 Sand Canyon Ave
Suite 220
Irvine, CA 92618-3787
Phone (949) 753-1882

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G046938CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce B Cleeremans MD a Prof Corp Neurology CurrentSince Nov 24, 2003 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

15825 Laguna Canyon Rd
Ste 202
Irvine, CA 92618
Phone (949) 653-7878

16405 Sand Canyon Ave
Ste 220
Irvine, CA 92618
Phone (949) 336-8150

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 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205042249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16405 SAND CANYON AVE STE 220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183787",
            "telephone_number": "949-753-1882",
            "fax_number": "949-727-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16405 SAND CANYON AVE STE 220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183787",
            "telephone_number": "949-753-1882",
            "fax_number": "949-727-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEEREMANS",
        "first_name": "BRUCE",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G046938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.