Organization Active NPI

Patrick K Brueggeman DPM LLC

  • Foot & Ankle Surgery Podiatrist
  • Melbourne, FL
National Provider Identifier
1366957839
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2457 Issued in FL
Legal business name
PATRICK K BRUEGGEMAN DPM LLC
Practice address
15 E Hibiscus Blvd
Melbourne, FL 32901-3101
Phone
(321) 508-7378
Fax
(321) 508-7378
NPI assigned
Dec 6, 2017
Last updated
Mar 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Authorized official

Name
Dr. Patrick Kent Brueggeman, DPMNPI 1376669150
Title
Owner
Phone
(321) 508-7378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO2457 FL Primary

Addresses

Primary practice location

15 E Hibiscus Blvd
Melbourne, FL 32901-3101

Mailing address

PO Box 4
Melbourne, FL 32902-0004
Phone (321) 508-7378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180315000957 FL Part B Supplier - Clinic/Group Practice 2264794015 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL; West Melbourne, FL; Titusville, FL; Rockledge, FL; Palm Bay, FL; Merritt Island, FL; Indian Harbour Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2339363Patrick K Brueggeman DPM LLC15 E Hibiscus Blvd, Melbourne, FL 32901RegistrationMar 1, 2028

National Provider Directory

National Provider Directory

Locations

2680 Croton Rd
Melbourne, FL 32935
Phone (321) 255-4783

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772755200000",
    "number": "1366957839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329020004",
            "telephone_number": "321-508-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013101",
            "telephone_number": "321-508-7378",
            "fax_number": "321-508-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK K BRUEGGEMAN DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "BRUEGGEMAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-508-7378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.