Melissa Bruketta, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

74723 Issued in CA

Practice address

30100 Town Center Dr Ste Yz
Laguna Niguel, CA 92677-2064

Phone

(949) 276-5401

NPI assigned

Aug 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

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.

• Rausch Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Laguna Niguel, CA
  • NPI 1538110861

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1508345877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TOWN CENTER DR STE YZ",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772064",
            "telephone_number": "949-276-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30100 TOWN CENTER DR STE YZ",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772064",
            "telephone_number": "949-276-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUKETTA",
        "first_name": "MELISSA",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "74723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED MASSAGE THERAPIST",
            "identifier": "74723",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Brosius-Rodriguez
• Cynthia Quinn Brown, LMFT
• Eva Anita Brown, LCSW
• Jason C Brown, M.D.
• Romana Irmgard Brown
• Ilese Buchanan, MS
• Jasmin Ruth Budhai
• Vyvyan Bui, M.S. SLP CCC
• Jason Vincent Bukich, MSAOM L.AC.
• Saghi Buloushi

• Massage Therapist in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.