Individual provider Active NPI

Michelle Sullivan Bruzatori, PA-C

  • Physician Assistant
  • Little Rock, AR
National Provider Identifier
1306205885
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-645 Issued in AR
Practice address
9500 Kanis Rd Ste 501
Little Rock, AR 72205-6389
Phone
(501) 227-9080
Fax
(501) 227-0410
NPI assigned
Feb 12, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health Group (645 clinicians)

Practice addresses (Care Compare)

9500 Kanis Rd
Suite 501
Little Rock, AR 72205-6389
Phone (501) 227-9080

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160429000506 AR Practitioner - Physician Assistant 0941509764 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-645ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Current
since Jun 17, 2025
Accepting new patients
Arkansas Health Group Current
since Jun 17, 2025
Accepting new patients
Arkansas Central Primary Care, PLLC Current
since Apr 8, 2016
Accepting new patients
Arkansas Health Group Current
since Feb 26, 2026
Accepting new patients
Physicians Network Inc Dba Cabot Medical Clinic Past Accepting new patients

Locations

2037 W Main St
Cabot, AR 72023
Phone (501) 843-4555

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9500 Kanis Rd
Ste 501
Little Rock, AR 72205
Phone (501) 217-2532

3201 Springhill Dr
Ste 130
North Little Rock, AR 72117
Phone (501) 955-2741

Interoperability endpoints

  • Direct secure messaging: mbruzatori257916@direct.baptist-healthar.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-645 AR Primary

Addresses

NPPES NPI Registry

Primary practice location

9500 Kanis Rd Ste 501
Little Rock, AR 72205-6389

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 227-9080

Other names 1

NPPES NPI Registry
  • Michelle Regan Sullivan Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 8, 2026.

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1306205885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-227-9080",
            "fax_number": "501-227-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD STE 501",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056389",
            "telephone_number": "501-227-9080",
            "fax_number": "501-227-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUZATORI",
        "first_name": "MICHELLE",
        "middle_name": "SULLIVAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "SULLIVAN",
            "middle_name": "REGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.