Individual provider Active NPI

Bruce Anderson

  • Nurse Practitioner
  • Hancock, MI
National Provider Identifier
1386049211
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704248670 Issued in MI
Practice address
500 Campus Dr
Hancock, MI 49930-1452
Phone
(906) 483-1000
NPI assigned
Nov 4, 2014
Last updated
Nov 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704248670 MI Primary

Addresses

Primary practice location

500 Campus Dr
Hancock, MI 49930-1452

Mailing address

500 Campus Dr
Hancock, MI 49930-1452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150113000063 MI Practitioner - Nurse Practitioner 5698099083 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians
Portage Physician Practices IncGroup PAC ID 6103053509, 56 clinicians

Practice addresses (Care Compare)

1000 Cedar St
Houghton, MI 49931-1978
Phone (906) 487-1710

500 Campus Dr
Hancock, MI 49930-1452

56720 Calumet Ave
Calumet, MI 49913-1967
Phone (906) 481-8952

56720 Calumet Ave
Suite B
Calumet, MI 49913-1905
Phone (906) 481-8952

921 W Sharon Ave
Houghton, MI 49931-1921
Phone (906) 483-1777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704248670MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Keweenaw CurrentSince Mar 12, 2026 Accepting new patients
Aspirus Keweenaw CurrentSince Mar 12, 2026 Accepting new patients
Portage Physician Practices Inc CurrentSince Nov 22, 2014 Accepting new patients
Aspirus Keweenaw CurrentSince Mar 12, 2026 Accepting new patients
Portage Physician Practices Inc CurrentSince Nov 22, 2014 Accepting new patients
Portage Hospital LLC Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

1000 Cedar St
Houghton, MI 49931
Phone (906) 482-8201

921 W Sharon Ave
Houghton, MI 49931
Phone (906) 483-1777

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

Interoperability endpoints

  • Direct secure messaging: bruce.anderson.1@8233.direct.athenahealth.com

Organizations & group practices 8

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1386049211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452",
            "telephone_number": "906-483-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRUCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704248670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.