Andrea Kathryn Bruss, M.D.
Individual provider Active NPI Family Medicine Physician · Waterville, OH
NPI 1205977352 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205977352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 89211 (OH)
- Practice address
- 900 Waterville Monclova Rd
Suite a
Waterville, OH 43566-1168 - Phone
- (419) 878-3010
- Fax
- (419) 878-3236
- NPI assigned
- Feb 10, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Cincinnati College of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health Physicians-North LLC
Practice addresses (Care Compare)
2213 Cherry St
Toledo, OH 43608-2603
2222 Cherry St
Toledo, OH 43608-2675
Hospital & facility affiliations
- Mercy St Vincent Medical Center
- University of Toledo Medical Center
- Promedica Toledo Hospital
- Wood County Hospital
- Henry County Hospital, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070815000237 | OH | Practitioner - Family Practice | 1557453958 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89211 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anne Grady Corporation | Current |
Accepting new patients | |
| Anne Grady Corporation | Current |
Accepting new patients | |
| Mercy Health Physicians - North, LLC | Current |
Accepting new patients | |
| Mercy Health Physicians-North LLC | Family Medicine | Current |
Accepting new patients |
| Mercy Health System Northern | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
1525 Eber Rd
Holland, OH 43528
Phone (419) 866-6500
5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911
2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013
Interoperability endpoints
- abruss90543@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 89211 | OH | Yes |
Addresses
Primary practice location
900 Waterville Monclova Rd
Suite a
Waterville, OH 43566-1168
Mailing address
4308 Rugby Dr
Toledo, OH 43614-5633
Phone (419) 389-1113
Other providers in Waterville, OH
- Alana Bedal
- Susan F Bennett
- Veronica A Blaesing
- Lindsey J Bostelman
- Browning Masonic Community
- Mark R Bruss
- Buckeye Forest at Waterville
- Jan Dale Castanza
- Barbara Jane Chaney
- Lynne Chapman I
All providers in Waterville, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.