Scott R Brundage, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

045016 Issued in MI

Practice address

2060 East Paris Avenue SE
Suite 150
Grand Rapids, MI 49546

Phone

(616) 454-1256

Fax

(616) 454-0308

NPI assigned

Dec 27, 2006

Last updated

Feb 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Rapids Plastic Surgery PLC

  dba Centre for Plastic Surgery

  • Ambulatory Surgical Clinic/Center
  • Grand Rapids, MI
  • NPI 1184815417
  Authorized official Same address or phone

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1265597223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 EAST PARIS AVENUE SE",
            "address_2": "SUITE 150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-454-1256",
            "fax_number": "616-454-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 EAST PARIS AVENUE SE",
            "address_2": "SUITE 150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-454-1256",
            "fax_number": "616-454-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNDAGE",
        "first_name": "SCOTT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "045016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Diane Bruinsma, MA
• John David Bruinsma, DDS
• Caitlin Brummel, BSW, QIDP
• Katrina Ann Brummel, PA-C
• Rebecca Marie Brummel, BS
• Debra Christine Brunette, RD
• Leonard Anthony Brunette, MD
• Marissa Bruni, PA-C
• Michael Patrick Brunner, M.D.
• Oriana Christina Bruno, LLP

• Plastic Surgery Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.