Individual provider Active NPI

Patrick Bruno, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Richmond, IN
National Provider Identifier
1639170509
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
35096568 Issued in OH
Practice address
4265 S a St
Richmond, IN 47374-6049
Phone
(765) 962-8843
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35.096568 OH
Addiction Medicine (Internal Medicine) Physician 207RA0401X 35096568 OH Primary

Addresses

Primary practice location

4265 S a St
Richmond, IN 47374-6049

Mailing address

3535 Lee Rd
Shaker Heights, OH 44120-5122
Phone (216) 417-6166

Other practice location 1

140 Fox Rd
suite 102
Van Wert, OH 45891-2475
Phone (419) 238-3047

Other practice location 2

3535 Lee Rd
Shaker Heights, OH 44120-5122
Phone (216) 417-6166

Other identifiers 1

IdentifierTypeStateIssuer
34165000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20110303000108 OH Practitioner - Addiction MedicinePractitioner - Obstetrics/Gynecology 8123003621 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.096568OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone CurrentSince Apr 15, 2019 Accepting new patients
Richmond Treatment Center, LLC CurrentSince Oct 1, 2025 Accepting new patients
Ohioguidestone Current Accepting new patients
Ohioguidestone CurrentSince Apr 15, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

4265 S A St
Richmond, IN 47374
Phone (765) 962-8843

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

3500 Carnegie Ave
Cleveland, OH 44115
Phone (440) 260-8327

1624 Tiffin Ave
Ste D
Findlay, OH 45840
Phone (419) 422-7800

885 Commerce Dr
Perrysburg, OH 43551
Phone (419) 330-1050

Organizations & group practices 5

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1639170509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 LEE RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441205122",
            "telephone_number": "216-417-6166",
            "fax_number": "216-417-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4265 S A ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473746049",
            "telephone_number": "765-962-8843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Fox Rd",
            "address_2": "suite 102",
            "address_purpose": "LOCATION",
            "city": "Van Wert",
            "state": "OH",
            "postal_code": "458912475",
            "country_code": "US",
            "telephone_number": "419-238-3047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Lee Rd",
            "address_purpose": "LOCATION",
            "city": "Shaker Heights",
            "state": "OH",
            "postal_code": "441205122",
            "country_code": "US",
            "telephone_number": "216-417-6166",
            "fax_number": "216-417-8676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35.096568",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35096568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34165000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.