Individual provider Active NPI

Bruce John Anderson, MD

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1497783955
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32095 Issued in MN
Practice address
410 Church St SE
Minneapolis, MN 55455-0222
Phone
(612) 625-8400
Fax
(612) 677-3211
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32095 MN Primary

Addresses

Primary practice location

410 Church St SE
Minneapolis, MN 55455-0222

Mailing address

410 Church St SE
Minneapolis, MN 55455-0222
Phone (612) 625-8400

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040609000911 MN Practitioner - Family Practice 0042293243

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

410 Church St SE
Minneapolis, MN 55455-0222

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota CurrentSince Jan 30, 2012 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince Jan 30, 2012 Accepting new patients

Locations

410 Church St SE
Minneapolis, MN 55455
Phone (612) 625-8400

410 Church St SE
#W235
Minneapolis, MN 55455

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1497783955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-8400",
            "fax_number": "621-677-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-8400",
            "fax_number": "612-677-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRUCE",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "32095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.