Timothy Brunelle

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

5524 Issued in CO

Practice address

255 Canyon Blvd Ste 200
Boulder, CO 80302-4954

Phone

(720) 744-0577

NPI assigned

Jun 20, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Neuroworks LLC

  • Clinical Neuropsychologist
  • Boulder, CO
  • NPI 1184176067
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1225488349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 CANYON BLVD STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024954",
            "telephone_number": "720-744-0577",
            "fax_number": "720-638-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 CANYON BLVD STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024954",
            "telephone_number": "720-744-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNELLE",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "5524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Bruder, CNIM
• Richard D. Bruess, OD
• Christine Marie Brumback, OTR
• Marissa Brun, LMFT
• Shara Brun, MA, LPC
• Luciana Erin Brunscheen, LPC, LAC
• Pierre Joseph Brunschwig, MD
• Deborah Brunson, M.D.
• Tyana Bruso, HIS/HAD
• Bryan Handwork Psychiatric Services

• Clinical Neuropsychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Neuropsychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.