Bruce Irwin Ackerman, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC002030L Issued in PA

Practice address

2417 Welsh Road
Suite 21 #240
Philadelphia, PA 19114

Phone

(215) 334-5700

Fax

(215) 334-5774

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: drbruceackerman@direct.practicefusion.com

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1316945983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 WELSH ROAD",
            "address_2": "STE 21 #240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141509",
            "telephone_number": "215-334-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 WELSH ROAD",
            "address_2": "SUITE 21 #240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19114",
            "telephone_number": "215-334-5700",
            "fax_number": "215-334-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "BRUCE",
        "middle_name": "IRWIN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2021-11-09",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002030L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE  ID#",
            "identifier": "5677430",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SC002030L15493",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054016601",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0060614000",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drbruceackerman@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "drbruceackerman direct message mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1602 S Broad St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191451509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Seibert Acker, MD
• Kate Acker, CRNP
• Maureen Acker, CRNA
• Michael A Acker, MD
• Rachael Acker, MD
• Kendra Ackerman, PA-C
• Kevin Ackerman
• Nicole Ackerman
• Sarah Alexandra Ackerman, DNP, FNP-C, CEN
• Stacey L Ackerman, MD

• Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.