Bruce R. Douglas, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

37107 Issued in MN

Practice address

200 1St St SW
Rochester, MN 55905-0001

Phone

(507) 284-2511

NPI assigned

Dec 21, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Diagnostic Radiology

Education

University of Wisconsin School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of the Fox Valley SCGroup PAC ID 0446152748, 73 clinicians

Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009
• Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
• Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334
• Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
• Thedacare Medical Center - Shawano Hospital, Shawano, WI, CCN 521346

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Radiology Associates of the Fox Valley, SC

  • Diagnostic Radiology Physician
  • Neenah, WI
  • NPI 1477539443
  Medicare reassignment Care Compare group NPD
• Thedacare, Incorporated

  dba ThedaCare Physicians

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment Care Compare group NPD
• Madison Radiologists S C

  • Diagnostic Radiology Physician
  • Madison, WI
  • NPI 1871573725
  Medicare reassignment NPD
• Thedacare, Incorporated

  dba ThedaCare Behavioral Health

  • Counselor
  • Menasha, WI
  • NPI 1306959515
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension NE Wisconsin, Inc

  • Ambulatory Surgical Clinic/Center
  • Menasha, WI
  • NPI 1124075536

  Hospital

  Care Compare affiliation
• Ascension NE Wisconsin, Inc

  dba Ascension NE Wisconsin-St Elizabeth Campus

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638
  Care Compare affiliation
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  Care Compare affiliation
• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1013995521
  Care Compare affiliation
• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1710333893
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc

  dba ThedaCare Medical Center Orthopedics, Spine, and Pain

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1740920909
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1497119218
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1689038408
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  dba WI Veterans Village Physical Therapy

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1831773589
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1902832306
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  dba ThedaCare Medical Center - Fond Du Lac

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1912721002
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  dba ThedaCare Medical Center - Oshkosh

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1912880329
  Care Compare affiliation

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568448553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "BRUCE",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "45258",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "37107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34334000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Dotzler, MD, PHD
• Mary E Doucette, RN
• Brian M Dougan, M.D.
• Stephen S Dougherty, CRNA
• Molly J Doughty, PA-C
• Lisa Lynne Douglas, RN
• Rachel Douglas, D.O.
• Brenton William Douglass, MD
• Nita Nith Doung, MEDICAL INTERPRETER
• Miloslava Kamila Dousa, M.D.

• Diagnostic Radiology Physician in Rochester, MN
• Providers in Rochester, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.