Active NPI
Todd Harold Bruss, ATC, LAT, CSCS, PA-C
- Physician Assistant
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3058
- Practice address
- 1110 Kepler Dr
Green Bay, WI 54311-8306 - Phone
- (920) 288-5555
- Fax
- (920) 288-5550
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3058 | WI | Primary |
| Athletic Trainer | 2255A2300X | 350-039 | WI |
Addresses
Primary practice location
1110 Kepler Dr
Green Bay, WI 54311-8306
Mailing address
1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 490-9046
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417178443 | Medicaid | WI |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tbruss62592@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | tbruss62592@direct.myadvocateaurora.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1160 Kepler Dr
Green Bay, WI 54311-8321
Phone (920) 288-5555
1910 Alabama St
Sturgeon Bay, WI 54235-3532
Phone (920) 743-4844
2845 Greenbrier Rd
Green Bay, WI 54311-6519
3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-3187
Hospital & facility affiliations
- Aurora Baycare Medical Ctr
- Aurora Medical Center Bay Area
- Door County Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3058 | WI | MD | Dentist |
| 350-039 | WI | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Clinic LLP | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Arthroscopic Surgery Center, LLC | Past | Accepting new patients |
Locations
277 N Altenhofen Dr
Grand Chute, WI 54913
Phone (920) 212-3609
1035 Kepler Dr
Green Bay, WI 54311
1160 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-5400
2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400
164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055
1110 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-4712
501 N 10th St
Manitowoc, WI 54220
Phone (920) 682-6376
3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066
108 S 10th Ave
Sturgeon Bay, WI 54235
Phone (920) 746-7955
1910 Alabama St
Sturgeon Bay, WI 54235
Phone (920) 746-7200
Interoperability endpoints
- tbruss62592@direct.myadvocateaurora.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Green Bay, WI
- NPI 1588609648
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Ambulatory Surgical Clinic/Center
- Appleton, WI
- NPI 1134140122
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Marinette, WI
- NPI 1043397177
-
- Clinical Medical Laboratory
- Marinette, WI
- NPI 1083791115
Hospital
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1255387726
-
- Critical Access Hospital
- Sturgeon Bay, WI
- NPI 1093743874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1417178443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 KEPLER DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543118320",
"telephone_number": "920-490-9046",
"fax_number": "920-405-8005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 KEPLER DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543118306",
"telephone_number": "920-288-5555",
"fax_number": "920-288-5550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSS",
"first_name": "TODD",
"middle_name": "HAROLD",
"name_prefix": "Mr.",
"credential": "ATC, LAT, CSCS, PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "3058",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "350-039",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1417178443",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tbruss62592@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1160 Kepler Dr",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543088970",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1160 Kepler Dr",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543088970",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tbruss62592@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "1160 Kepler Dr",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543088970",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.
- 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.