Individual provider Active NPI

John Bret Bruder, MD

  • Emergency Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1205830759
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35081559 Issued in OH
Practice address
3131 Queen City Ave
Cincinnati, OH 45238-2316
Phone
(513) 557-3333
Fax
(513) 557-3332
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01075910A IN
Family Medicine Physician 207Q00000X 35907 KY
Emergency Medicine Physician 207P00000X 35081559 OH Primary

Addresses

Primary practice location

3131 Queen City Ave
Cincinnati, OH 45238-2316

Mailing address

1472 Solutions Ctr
Chicago, IL 60677-1004
Phone (513) 557-3333

Other identifiers 3

IdentifierTypeStateIssuer
200498590MedicaidIN
2351066MedicaidOH
64076219MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20051216000005 OH Practitioner - Emergency Medicine 5496776528 Reassigns benefits to 1 organization
I20200331000946 IN Practitioner - Emergency Medicine 5496776528 Reassigns benefits to 2 organizations
I20220620000766 KY Practitioner - Emergency Medicine 5496776528 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35081559OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Company of Tennessee PLLC Emergency Medicine CurrentSince Sep 25, 2024 Accepting new patients
Indiana Emergency Professionals PC Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Western Healthcare Services Kentucky LLC Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients

Locations

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

720 S 6th St
Monticello, IN 47960
Phone (574) 583-1776

8885 State Road 237
Tell City, IN 47586
Phone (812) 547-0185

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1205830759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1472 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771004",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 QUEEN CITY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382316",
            "telephone_number": "513-557-3333",
            "fax_number": "513-557-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDER",
        "first_name": "JOHN",
        "middle_name": "BRET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01075910A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "35907",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35081559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200498590",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2351066",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64076219",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.