Michael P Bruderly, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN273624 Issued in OH

Practice address

1000 Dutch Ridge Rd
Beaver, PA 15009-9727

Phone

(724) 773-4621

Fax

(724) 773-4696

NPI assigned

Nov 12, 2007

Last updated

Nov 12, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Dayton Anesthesia & Pain Services, LLC

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1629401898

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1588844179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6432 W GARFIELD RD",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444609220",
            "telephone_number": "330-502-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DUTCH RIDGE RD",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099727",
            "telephone_number": "724-773-4621",
            "fax_number": "724-773-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDERLY",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN273624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Everall Brennan, M.D.
• George W Brett, MD
• Bridgewater Chiropractic, LLC
• Brighton Radiology Associates, P.C.
• Michael C Brody, M.D.
• Budding Smiles of Beaver
• Susan Elizabeth Bull, CRNP
• Cathy L Bullion, MPT
• Michelle Butcher, LPC
• Cheryl Ann Cable

• Certified Registered Nurse Anesthetist in Beaver, PA
• Providers in Beaver, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.