Individual provider Active NPI

Nancy L Bruda, MD

  • Anesthesiology Physician
  • Fayetteville, AR
National Provider Identifier
1518915503
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-5371 Issued in AR
Practice address
3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Phone
(918) 664-9892
Fax
(918) 664-2521
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 118708 MO
Anesthesiology Physician 207L00000X E-5371 AR Primary

Addresses

Primary practice location

3215 N Northhills Blvd
Fayetteville, AR 72703-4424

Mailing address

PO Box 1867
Fayetteville, AR 72702-1867
Phone (918) 664-9892

Other practice location 1

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-6350

Other identifiers 7

IdentifierTypeStateIssuer
203843420MedicaidMO
26178025OtherMOBCBS NUMBER
200126940AMedicaidOK
P00664032OtherARRAILROAD MEDICARE
100317990BMedicaidMO
771081401OtherARARKANSAS BREASTCARE
136770001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20140814000514 MO Practitioner - Anesthesiology 7113002676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Michigan State University College of Human Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.52 of 100Reported as group
Quality
73.6
Promoting interoperability
100
Improvement activities
40
Cost
81.46

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118708MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center Current Accepting new patients
Heartland Regional Medical Center CurrentSince Jul 6, 2014 Accepting new patients
University Health Physicians Past Accepting new patients
Truman Medical Centers, Inc. Past Accepting new patients
Westport Anesthesia Services of Missouri, PC Anesthesiology Past Accepting new patients

Locations

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1213

Interoperability endpoints

  • Direct secure messaging: nancy.bruda@direct.mymlc.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1518915503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1867",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021867",
            "telephone_number": "918-664-9892",
            "fax_number": "918-664-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "918-664-9892",
            "fax_number": "918-664-2521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5325 Faraon St",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645063488",
            "country_code": "US",
            "telephone_number": "816-271-6350",
            "fax_number": "816-271-6753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUDA",
        "first_name": "NANCY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "118708",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-5371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203843420",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "26178025",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200126940A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00664032",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317990B",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BREASTCARE",
            "identifier": "771081401",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136770001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.