Active NPI
Katherine Renee Bruch, MD
- Student in an Organized Health Care Education/Training Program
- Boston, MA
National Provider Identifier
1689376469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 726-2000
- NPI assigned
- Mar 17, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000
Other practice location 1
75 Francis St
Boston, MA 02115-6106
Phone (617) 732-5500
Other practice location 2
150 S Huntington Ave
Boston, MA 02130-4817
Phone (617) 232-9500
Other practice location 3
940 Belmont St
Brockton, MA 02301-5596
Phone (508) 583-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241231000544 | MA | Order and Referring Only - Internal Medicine | 8628505740 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720224000000",
"number": "1689376469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-726-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-726-2000"
}
],
"practiceLocations": [
{
"address_1": "75 Francis St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021156106",
"country_code": "US",
"telephone_number": "617-732-5500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "150 S Huntington Ave",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021304817",
"country_code": "US",
"telephone_number": "617-232-9500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "940 Belmont St",
"address_purpose": "LOCATION",
"city": "Brockton",
"state": "MA",
"postal_code": "023015596",
"country_code": "US",
"telephone_number": "508-583-4500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRUCH",
"first_name": "KATHERINE",
"middle_name": "RENEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-17",
"last_updated": "2024-07-06",
"certification_date": "2024-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; 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.