Bruce Allen, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

55522 Issued in KY

Practice address

1025 Saint Joseph LN
London, KY 40741-8345

Phone

(606) 330-2370

Fax

(606) 877-1593

NPI assigned

Feb 9, 2007

Last updated

Jun 16, 2021By 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 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA, IN2 enrollments

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 2

Specialty

General Surgery

Education

Stanford University School of Medicine, 1974

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital and Health Care Center Hospital, Jasper, IN, CCN 150115

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ballen1046953@direct.deaconess.com
• Direct secure messaging: ballen34837@direct.mhhcc.org

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.

• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment NPD
• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Evansville, IN
  • NPI 1306344817

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  Medicare reassignment NPD (past)
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• Deaconess Memorial Medical Center Inc

  dba Memorial Healthcare of Huntingburg

  • Emergency Medicine Physician
  • Huntingburg, IN
  • NPI 1114120128
  NPD
• Deaconess Memorial Medical Center Inc

  dba Deaconess Comprehensive Pain Management - Jasper

  • Pain Medicine Physician
  • Jasper, IN
  • NPI 1457164543
  NPD
• Deaconess Memorial Medical Center Inc

  dba Memorial Surgical Associates

  • Surgery Physician
  • Jasper, IN
  • NPI 1912579574
  NPD
• Deaconess Specialty Physicians Inc

  • Family Medicine Physician
  • Huntingburg, IN
  • NPI 1831980945
  NPD
• Deaconess Specialty Physicians Inc

  • Cardiovascular Disease Physician
  • Washington, IN
  • NPI 1891586079
  NPD

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

• Deaconess Memorial Medical Center, Inc.

  dba Memorial Hospital & Health Care Center

  • General Acute Care Hospital
  • Jasper, IN
  • NPI 1003895947
  Care Compare affiliation

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1639210743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-2370",
            "fax_number": "606-330-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SAINT JOSEPH LN",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407418345",
            "telephone_number": "606-330-2370",
            "fax_number": "606-877-1593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 S San Mateo Dr",
            "address_2": "Suite 360",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944013857",
            "country_code": "US",
            "telephone_number": "650-343-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G30889",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "55522",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G30889",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAL LICENSE",
            "identifier": "55522",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G30889",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY34803Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali Family, LLC
• Amjad Ali, M.D.
• Muhammad Ali, M.D.
• All About Sleep Inc (Advance Sleep Center)
• All in Recovery, LLC
• Emily Jade Allen, FNP-C
• Jeremy W Allen, DMD
• Lindsay Allen
• Matt Allen, CPSS
• Olivia Leigh Allen, M.S.

• Surgery Physician in London, KY
• Providers in London, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.