Bruce G Deckinga, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MI43030312 Issued in MI

Practice address

8872 Deer Run
Petoskey, MI 49770-8593

Phone

(231) 347-7681

NPI assigned

Sep 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mercy Hospital Grayling

  • Hematology & Oncology Physician
  • Grayling, MI
  • NPI 1427489509
  NPD (past)
• Mercy Professional Services

  • Internal Medicine Physician
  • Grayling, MI
  • NPI 1912951468
  NPD (past)

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1508050311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8872 DEER RUN",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708593",
            "telephone_number": "231-347-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8872 DEER RUN",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708593",
            "telephone_number": "231-347-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKINGA",
        "first_name": "BRUCE",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "MI43030312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David R Hunter DPM PC
• Mark W Dawson, RPH
• Trudy E Day, M.S.N., N.P.
• Jill Susanne Decker, M.D.
• Todd Edward Decker, MD
• John J Degroot, O.D.
• Suzanne C Delmerico, PTA
• Chandra L Delorenzo, DO
• Jane M Denay, CFNP
• Karen Denbesten, MD

• Surgery Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.