Individual provider Active NPI

James Edward Bruns, O.D.

  • Optometrist
  • Rohnert Park, CA
National Provider Identifier
1306926787
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5247T Issued in CA
Practice address
6180 State Farm Dr
Rohnert Park, CA 94928-2135
Phone
(707) 584-7294
Fax
(707) 584-4728
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5247T CA Primary

Addresses

Primary practice location

6180 State Farm Dr
Rohnert Park, CA 94928-2135

Mailing address

6180 State Farm Dr
Rohnert Park, CA 94928-2135
Phone (707) 584-7294

Other identifiers 1

IdentifierTypeStateIssuer
SD0052470MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000639 CA Practitioner - Optometry 6608034251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6180 State Farm Dr
Rohnert Park, CA 94928-2135
Phone (707) 584-7294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5247TCAMDOptometrist
5247CAMDFamily Nurse Practitioner

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1306926787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6180 STATE FARM DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282135",
            "telephone_number": "707-584-7294",
            "fax_number": "707-584-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6180 STATE FARM DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282135",
            "telephone_number": "707-584-7294",
            "fax_number": "707-584-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5247T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0052470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

Verify at the official NPI Registry.