Individual provider Active NPI

Karen Bruder, MD

  • Obstetrics & Gynecology Physician
  • Tampa, FL
National Provider Identifier
1699788380
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME83126 Issued in FL
Practice address
12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Phone
(813) 974-2919
NPI assigned
Aug 14, 2006
Last updated
Oct 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME83126 FL Primary

Addresses

Primary practice location

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742

Mailing address

PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201

Other practice location 1

2 Tampa General Cir
Tampa, FL 33606-3603
Phone (813) 974-2201

Other identifiers 2

IdentifierTypeStateIssuer
03224OtherFLBLUE CROSS BLUE SHIELD
262238600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbruder6328@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100420000959 FL Practitioner - Obstetrics/Gynecology 9830226067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Perelman School of Med at the University of Pennsylvania, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Tampa General Cir
Tampa, FL 33606-3603
Phone (813) 821-8038

2 Tampa General Circle
4TH Floor
Tampa, FL 33606-3603
Phone (813) 821-8038

5802 N 30TH St
Tampa, FL 33610-1469
Phone (813) 236-5100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME83126FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Aug 28, 2001 Accepting new patients
University Medical Service Association Inc Obstetrics & Gynecology CurrentSince Aug 28, 2001 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc Past Accepting new patients
M & D Care, Inc. D/B/a Women's Health Care Past Accepting new patients

Locations

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 974-1469

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

12901 N 30th St
Tampa, FL 33612
Phone (813) 974-0703

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

2 Tampa General Cir
Fl 4
University of Tampa, FL 33606
Phone (813) 259-8500

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1699788380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-974-2919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063603",
            "country_code": "US",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-2812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUDER",
        "first_name": "KAREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME83126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "03224",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262238600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbruder6328@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.