Individual provider Active NPI

Elinor J Bruders, FNP-BC, NP-C

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1619362308
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6280-33 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-6299
Fax
(414) 805-1514
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6280-33 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6299

Other practice location 1

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (704) 342-1900

Other practice location 2

342 N Water St Ste 600
Milwaukee, WI 53202-5715
Phone (651) 342-1039

Other identifiers 1

IdentifierTypeStateIssuer
1619362308MedicaidWI

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731014509 WI Practitioner - Nurse Practitioner 5597079848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1619362308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6299",
            "fax_number": "414-805-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6299",
            "fax_number": "414-805-1514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N16W24131 Riverwood Dr",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531881106",
            "country_code": "US",
            "telephone_number": "704-342-1900",
            "fax_number": "704-342-9571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "342 N Water St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532025715",
            "country_code": "US",
            "telephone_number": "651-342-1039",
            "fax_number": "651-342-1428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUDERS",
        "first_name": "ELINOR",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6280-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619362308",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.