Active NPI
Richard D. Bruess, OD
- Optometrist
- Boulder, CO
National Provider Identifier
1376539734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1549
- Practice address
- 6545 Gunpark Drive
Ste 250
Boulder, CO 80301-3350 - Phone
- (303) 530-1973
- Fax
- (303) 530-1973
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1549 | CO | Primary |
Addresses
Primary practice location
6545 Gunpark Drive
Ste 250
Boulder, CO 80301-3350
Mailing address
6545 Gunpark Drive
Ste 250
Boulder,, CO 80301-3350
Phone (303) 530-1973
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BRR33595 | Other | CO | BLUE CROSS BLUE SHIELD OF COLORADO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1549 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229558400000",
"number": "1376539734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6545 GUNPARK DRIVE",
"address_2": "STE 250",
"city": "BOULDER,",
"state": "CO",
"postal_code": "803013350",
"telephone_number": "303-530-1973",
"fax_number": "303-530-1973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6545 GUNPARK DRIVE",
"address_2": "STE 250",
"city": "BOULDER",
"state": "CO",
"postal_code": "803013350",
"telephone_number": "303-530-1973",
"fax_number": "303-530-1973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUESS",
"first_name": "RICHARD",
"middle_name": "D.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2008-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "1549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF COLORADO",
"identifier": "BRR33595",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.