Individual provider Active NPI

Michael John Brunsman, M.D.

  • General Practice Physician
  • Sun City, AZ
National Provider Identifier
1548421266
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
26483 Issued in AZ
Practice address
17220 N Boswell Blvd
Suite 225 E
Sun City, AZ 85373-2000
Phone
(623) 876-9100
Fax
(623) 876-9300
NPI assigned
Jun 25, 2008
Last updated
Jun 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 26483 AZ Primary

Addresses

Primary practice location

17220 N Boswell Blvd
Suite 225 E
Sun City, AZ 85373-2000

Mailing address

16025 N 4TH Dr
Phoenix, AZ 85023-4415
Phone (602) 298-4688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26483AZMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonspirit Oregon CurrentSince Sep 3, 2009 Accepting new patients
Commonspirit Oregon CurrentSince Sep 3, 2009 Accepting new patients

Locations

1514 SE Court Ave
Pendleton, OR 97801
Phone (541) 278-1348

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1548421266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16025 N 4TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850234415",
            "telephone_number": "602-298-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17220 N BOSWELL BLVD",
            "address_2": "SUITE 225 E",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853732000",
            "telephone_number": "623-876-9100",
            "fax_number": "623-876-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSMAN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "26483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.