Marissa Bruni, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601014143 Issued in MI

Practice address

1840 Wealthy St SE
Grand Rapids, MI 49506-2921

Phone

(616) 391-1730

NPI assigned

Jul 7, 2026

Last updated

Sep 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1783382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1699693614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DR SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416",
            "telephone_number": "616-975-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062921",
            "telephone_number": "616-391-1730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Michigan St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "616-391-1730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNI",
        "first_name": "MARISSA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-07",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601014143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699693614",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Marie Brummel, BS
• Scott R Brundage, MD
• Debra Christine Brunette, RD
• Leonard Anthony Brunette, MD
• Anne Bruni, ACNPC-AG
• Michael Patrick Brunner, M.D.
• Oriana Christina Bruno, LLP
• Logan Bruns
• Trisha M Bruns
• Ashley Nicole Brush, PA-C

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.