Individual provider Active NPI

Matthew Bruhn, PA

  • Physician Assistant
  • Hammond, LA
National Provider Identifier
1669070769
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
324782 Issued in LA
Practice address
15813 Paul Vega MD Dr Ste 100
Hammond, LA 70403-1431
Phone
(985) 230-2663
Fax
(985) 230-2665
NPI assigned
Oct 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 324782 LA Primary
Physician Assistant 363A00000X 1179318 LA

Addresses

Primary practice location

15813 Paul Vega MD Dr Ste 100
Hammond, LA 70403-1431

Mailing address

PO Box 3087
Hammond, LA 70404-3087
Phone (985) 230-3668

Other identifiers 1

IdentifierTypeStateIssuer
2541668MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://soapproxyprd.northoaks.org/nohsfhir/api/FHIR/R4/ North Oaks Physician Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201111002735 LA Practitioner - Physician Assistant 7517377054 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Oaks Medical Center LLCGroup PAC ID 2466629522, 317 clinicians

Practice addresses (Care Compare)

15790 Paul Vega MD Dr
Hammond, LA 70403-1434
Phone (985) 230-1683

Hospital & facility affiliations

  • North Oaks Medical Center Hospital, Hammond, LA, CCN 190015

Merit-based Incentive Payment System (MIPS)

Final score
86.91 of 100Reported as group
Quality
78.17
Promoting interoperability
100
Improvement activities
40
Cost
67.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1179318LAMDPhysician Assistant
324782LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Oaks Medical Center, LLC CurrentSince Jun 28, 2022 Accepting new patients
North Oaks Physician Group, LLC CurrentSince Nov 9, 2020 Accepting new patients
North Oaks Physician Group, LLC CurrentSince Nov 9, 2020 Accepting new patients

Locations

15784 Medical Arts Dr
Ste B
Hammond, LA 70403
Phone (985) 230-7400

15813 Paul Vega Md Dr
Ste 402
Hammond, LA 70403
Phone (985) 230-7350

15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682

15813 Paul Vega Md Dr
Ste 200
Hammond, LA 70403
Phone (985) 230-7650

15784 Medical Arts Dr
Hammond, LA 70403

15813 Paul Vega Md Dr
Hammond, LA 70403

15813 Paul Vega Md Dr
Ste 401B
Hammond, LA 70403
Phone (985) 230-7870

15813 Paul Vega Md Dr
Ste 100
Hammond, LA 70403
Phone (985) 230-2663

17199 Spring Ranch Rd
Ste 100
Livingston, LA 70754
Phone (225) 686-4900

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1669070769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3087",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704043087",
            "telephone_number": "985-230-3668",
            "fax_number": "985-370-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15813 PAUL VEGA MD DR STE 100",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031431",
            "telephone_number": "985-230-2663",
            "fax_number": "985-230-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUHN",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-12",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "324782",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "1179318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2541668",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://soapproxyprd.northoaks.org/nohsfhir/api/FHIR/R4/",
            "affiliation": "Y",
            "affiliationName": "North Oaks Physician Group, LLC",
            "address_1": "15813 Paul Vega Md Dr Ste 401B",
            "city": "Hammond",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704031426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.