NPIMap

Individual provider Active NPI

Michael Lynn Bruce, MD

  • Diagnostic Radiology Physician
  • Baton Rouge, LA
National Provider Identifier
1326027632
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
021314 Issued in LA
Practice address
8230 Summa Ave Ste C
Baton Rouge, LA 70809-3421
Phone
(225) 757-0552
Fax
(225) 763-9997
NPI assigned
Jan 13, 2006
Last updated
Apr 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 021314 LA Primary

Addresses

Primary practice location

8230 Summa Ave Ste C
Baton Rouge, LA 70809-3421

Mailing address

8230 Summa Ave Ste C
Baton Rouge, LA 70809-3421
Phone (225) 757-0552

Other identifiers 1

IdentifierTypeStateIssuer
1681148MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051118000143 LA Practitioner - Diagnostic Radiology 7517986557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in New Orleans, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates LLCGroup PAC ID 8628041464, 83 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 757-0552

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021314LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates LLC Diagnostic Radiology CurrentSince Oct 17, 2005 Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

100 Womans Way
Baton Rouge, LA 70817
Phone (225) 293-2324

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

7135 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 765-7875

8230 Summa Ave
Ste C
Baton Rouge, LA 70809

1100 N 18th St
Ste 100
Monroe, LA 71201
Phone (318) 361-9900

900 Johnson St
Tallulah, LA 71282
Phone (318) 395-2241

Organizations & group practices 2

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.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1326027632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 SUMMA AVE STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093421",
            "telephone_number": "225-757-0552",
            "fax_number": "225-763-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 SUMMA AVE STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093421",
            "telephone_number": "225-757-0552",
            "fax_number": "225-763-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "MICHAEL",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "021314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1681148",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.