Individual provider Active NPI

Bruce R Elwell, DO

  • Family Medicine Physician
  • Barneveld, NY
National Provider Identifier
1659360659
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
186462-1 Issued in NY
Practice address
7980 State Route 12
Barneveld, NY 13304-2536
Phone
(315) 624-8440
Fax
(315) 624-8450
NPI assigned
Oct 21, 2005
Last updated
Apr 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 186462-1 NY Primary

Addresses

Primary practice location

7980 State Route 12
Barneveld, NY 13304-2536

Mailing address

7980 State Route 12
Barneveld, NY 13304-2536
Phone (315) 624-8440

Other identifiers 1

IdentifierTypeStateIssuer
01352818MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080416000524 NY Practitioner - Family Practice 1951489905 Reassigns benefits to 1 organization
Practice locations: Marcy, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
18642NYMDMental Health Counselor
186462-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Mar 10, 2008 Accepting new patients
MVHS Inc Family Medicine CurrentSince Mar 10, 2008 Accepting new patients

Locations

7980 State Route 12
Barneveld, NY 13304
Phone (315) 624-8440

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

4401 Middle Settlement Rd
New Hartford, NY 13413
Phone (315) 734-3471

120 Hobart St
Utica, NY 13501
Phone (315) 798-1149

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

Interoperability endpoints

  • Direct secure messaging: belwell@hiemail.healtheconnections.org
  • Direct secure messaging: belwell13459@mvhealthsystem.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1659360659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7980 STATE ROUTE 12",
            "city": "BARNEVELD",
            "state": "NY",
            "postal_code": "133042536",
            "telephone_number": "315-624-8440",
            "fax_number": "315-624-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7980 STATE ROUTE 12",
            "city": "BARNEVELD",
            "state": "NY",
            "postal_code": "133042536",
            "telephone_number": "315-624-8440",
            "fax_number": "315-624-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELWELL",
        "first_name": "BRUCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "186462-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01352818",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barneveld, NY

Sources for this page

Verify at the official NPI Registry.