Bruce R Elwell, DO
Individual provider Active NPI Family Medicine Physician · Barneveld, NY
NPI 1659360659 · NPPES record last updated Apr 13, 2015
Key facts
- NPI
- 1659360659
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 186462-1 (NY)
- Practice address
- 7980 State Route 12
Barneveld, NY 13304-2536 - Phone
- (315) 624-8440
- Fax
- (315) 624-8450
- NPI assigned
- Oct 21, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080416000524 | NY | Practitioner - Family Practice | 1951489905 |
Reassigns benefits to 1 organization Practice locations: Marcy, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18642 | NY | MD | Mental Health Counselor |
| 186462-1 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MVHS Inc | Family Medicine | Current |
Accepting new patients |
| MVHS Inc | Current |
Accepting new patients |
Locations
7980 State Route 12
Barneveld, NY 13304
Phone (315) 624-8440
4401 Middle Settlement Rd
New Hartford, NY 13413
Phone (315) 734-3471
1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222
2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100
1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567
120 Hobart St
Utica, NY 13501
Phone (315) 798-1149
Interoperability endpoints
- belwell13459@mvhealthsystem.direct-ci.com
- belwell@hiemail.healtheconnections.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 186462-1 | NY | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01352818 | Medicaid | NY |
Other providers in Barneveld, NY
- Samantha Marie Buley
- Amber M Cain
- Trisha Marie Cashman
- Kiana Cummings
- Michael Dejesus
- Danah Kathryn Ernst
- Hans W Ernst
- James Fisher
- Noel F Gaige
- Mary Catherine Gajewski
All providers in Barneveld, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.