Individual provider Active NPI

Bruce D Robertson, LICSW

  • Clinical Social Worker
  • Bremerton, WA
National Provider Identifier
1598756512
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006200 Issued in WA
Practice address
2512 Wheaton Way
Sutie B
Bremerton, WA 98310
Phone
(360) 782-5700
Fax
(360) 782-5899
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW00006200 WA Primary

Addresses

Primary practice location

2512 Wheaton Way
Sutie B
Bremerton, WA 98310

Mailing address

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 782-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170505001201 WA Practitioner - Clinical Social Worker 0941587612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2512 Wheaton Way
Suite B
Bremerton, WA 98310-3303
Phone (360) 782-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW00006200WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group Current Accepting new patients

Locations

2520 Cherry Ave
#30721
Bremerton, WA 98310

2512 Wheaton Way
Ste B
Bremerton, WA 98310
Phone (360) 782-5700

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

9633 Levin Rd NW
Ste 103
Silverdale, WA 98383
Phone (360) 337-8200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1598756512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 CHERRY AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98310",
            "telephone_number": "360-782-5700",
            "fax_number": "360-782-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 WHEATON WAY",
            "address_2": "SUTIE B",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98310",
            "telephone_number": "360-782-5700",
            "fax_number": "360-782-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "BRUCE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.