Individual provider Active NPI

Molly E Bruggeman, DPT

  • Physical Therapist
  • Monroeville, PA
National Provider Identifier
1235404955
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT024573 Issued in PA
Practice address
2490 Mosside Blvd
Monroeville, PA 15146-4236
Phone
(412) 717-3975
Fax
(412) 717-3979
NPI assigned
Mar 13, 2012
Last updated
Sep 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physical Therapist 225100000X PT024573 PA Primary

Addresses

Primary practice location

2490 Mosside Blvd
Monroeville, PA 15146-4236

Mailing address

480 Johnson Rd Ste 303
Washington, PA 15301-8936
Phone (724) 223-2061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT024573PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1235404955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 JOHNSON RD STE 303",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153018936",
            "telephone_number": "724-223-2061",
            "fax_number": "724-223-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 MOSSIDE BLVD",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151464236",
            "telephone_number": "412-717-3975",
            "fax_number": "412-717-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUGGEMAN",
        "first_name": "MOLLY",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.