Individual provider Active NPI

Julia A. Bruckner, M.D.

  • Diagnostic Radiology Physician
  • Milwaukee, WI
National Provider Identifier
1215965892
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
48201 Issued in WI
Practice address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone
(414) 352-3100
Fax
(414) 247-4597
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 48201 WI Primary

Addresses

Primary practice location

3003 W Good Hope Rd
Milwaukee, WI 53209-2042

Mailing address

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Other identifiers 2

IdentifierTypeStateIssuer
P00449456OtherWIRR MEDICARE
34665800MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbruckner871@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48201WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Imaging Consultants, LLC Diagnostic Radiology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jbruckner871@direct.myadvocateaurora.org

Organizations & group practices 1

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1215965892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100",
            "fax_number": "414-247-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "JULIA",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "48201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00449456",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34665800",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbruckner871@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3003 W Good Hope Rd",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532092042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3003 W Good Hope Rd",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532092042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.