Bruce H. Churchill, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

76093 Issued in MA

Practice address

75 Mount Auburn St
Cambridge, MA 02138-4960

Phone

(617) 495-8414

Fax

(617) 496-0560

NPI assigned

Jul 18, 2006

Last updated

Jan 14, 2015By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• President & Fellows of Harvard College

  dba Harvard University Health Services

  • Multi-Specialty Clinic/Center
  • Cambridge, MA
  • NPI 1952366312
  Medicare reassignment NPD
• President and Fellows of Harvard College

  dba Harvard Dental Center TP

  • General Practice Dentistry
  • Boston, MA
  • NPI 1972761807
  NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1326066150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-8414",
            "fax_number": "617-496-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-8414",
            "fax_number": "617-496-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "BRUCE",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "76093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "J14119",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tze Wah Chu
• Eunice Y Chuang, M.D.
• Yenkuei Chuang, PH.D.
• Sakil Chundydyal, M.D.
• Meghan Marie Church, PT
• Robyn Churchill, CNM
• Helen Chwaliszewski, LICSW
• Ciampa Apothecary
• Domenic J Ciampa, MSN
• Santo Ciappina, RPH

• Family Medicine Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.