Active NPI
Thomas P. Van Bruggen, M.D.
- Surgery Physician
- Wadena, MN
National Provider Identifier
1649387291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 25385
- Practice address
- 4 Deerwood Ave NW
Wadena, MN 56482-1253 - Phone
- (218) 631-1360
- Fax
- (218) 631-7571
- NPI assigned
- Aug 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 25385 | MN | Primary |
Addresses
Primary practice location
4 Deerwood Ave NW
Wadena, MN 56482-1253
Mailing address
4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone (218) 631-1360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25385 | MN | MD | Surgery Physician |
Interoperability endpoints
- tvanbruggen13082@direct.centracare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649387291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 DEERWOOD AVE NW",
"city": "WADENA",
"state": "MN",
"postal_code": "564821253",
"telephone_number": "218-631-1360",
"fax_number": "218-631-7571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 DEERWOOD AVE NW",
"city": "WADENA",
"state": "MN",
"postal_code": "564821253",
"telephone_number": "218-631-1360",
"fax_number": "218-631-7571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN BRUGGEN",
"first_name": "THOMAS",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "25385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wadena, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.