Active NPI
John S Bruun, M.D.
- Surgical Critical Care Physician
- Nellis Afb, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Critical Care Physician
- License
- 15380
- Practice address
- 4700 Las Vegas Blvd N
Nellis Afb, NV 89191 - Phone
- (702) 653-3550
- NPI assigned
- Feb 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35.089020 | OH | |
| Surgical Critical Care Physician | 2086S0102X | 15380 | NV | Primary |
Addresses
Primary practice location
4700 Las Vegas Blvd N
Nellis Afb, NV 89191
Mailing address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone (702) 653-3550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Uniformed Services Uhs Fe Hebert School of Med, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 E Apple St
Suite 6258B
Dayton, OH 45409-2932
Phone (937) 208-5055
Hospital & facility affiliations
- Miami Valley Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.17 of 100
- Quality
- 65.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.7
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.089020 | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Health Specialists Inc | Current | Accepting new patients | |
| Premier Health Specialists Inc | Family Medicine | Current | Accepting new patients |
| Premier Health Specialists Inc | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Miami Valley Hospital | Past | Accepting new patients |
Locations
1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636
30 E Apple St
Ste 6258B
Dayton, OH 45409
Phone (937) 208-3186
30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300
450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Moraine, OH
- NPI 1194958223
Family Medicine
-
- Obstetrics & Gynecology Physician
- Springboro, OH
- NPI 1558667261
-
- Foot & Ankle Surgery Podiatrist
- Dayton, OH
- NPI 1902211287
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1073688354
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1073688354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535068800000",
"number": "1679547137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-653-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "89191",
"telephone_number": "702-653-3550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUUN",
"first_name": "JOHN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2018-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35.089020",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "NV",
"license": "15380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nellis Afb, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.