Active NPI
Michael John Brunsman, M.D.
- General Practice Physician
- Sun City, AZ
National Provider Identifier
1548421266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 26483
- 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, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26483 | AZ | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonspirit Oregon | Current | Accepting new patients | |
| Commonspirit Oregon | Current | 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.
-
dba St. Anthony Hospital Profee
- Multi-Specialty Clinic/Center
- Pendleton, OR
- NPI 1831169903
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.