Active NPI
Jacqueline Ann Bruss, PA-C
- Physician Assistant
- Osseo, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9016
- Practice address
- 50 Central Ave
Osseo, MN 55369-1241 - Phone
- (763) 587-7900
- Fax
- (763) 420-1901
- NPI assigned
- Jun 29, 2006
- Last updated
- Nov 7, 2022
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9016 | MN | Primary |
Addresses
Primary practice location
50 Central Ave
Osseo, MN 55369-1241
Mailing address
9201 W Broadway Ave Ste 601
Brooklyn Park, MN 55445-1924
Phone (763) 587-7900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 923706200 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jackie.bruss@nor.eclinicaldirectplus.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
50 Central Ave
Osseo, MN 55369-1241
Phone (763) 587-7900
5109 36TH Ave N
Crystal, MN 55422-2007
Phone (763) 587-7900
9825 Hospital Dr
Suite 300
Maple Grove, MN 55369-4768
Phone (763) 587-7900
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Clinic, PA | Current | Accepting new patients |
Locations
9201 W Broadway Ave
Ste 601
Minneapolis, MN 55445
Phone (763) 587-7933
50 Central Ave
Osseo, MN 55369
Phone (612) 588-4625
Interoperability endpoints
- jacqueline.bruss@nor.eclinicaldirectplus.com
Organizations & group practices 2
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.
-
dba Voyage Healthcare
- Multi-Specialty Clinic/Center
- Brooklyn Park, MN
- NPI 1407011760
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba North Memorial Ambulance Service
- Ambulance
- Brooklyn Center, MN
- NPI 1538195912
Hospital
-
dba North Memorial Health Specialty Center - Robbinsdale
- Medical Specialty Clinic/Center
- Robbinsdale, MN
- NPI 1699953000
Hospital
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1720016587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9201 W BROADWAY AVE STE 601",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554451924",
"telephone_number": "763-587-7900",
"fax_number": "763-587-7066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 CENTRAL AVE",
"city": "OSSEO",
"state": "MN",
"postal_code": "553691241",
"telephone_number": "763-587-7900",
"fax_number": "763-420-1901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSS",
"first_name": "JACQUELINE",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2022-11-07",
"certification_date": "2022-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "923706200",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jackie.bruss@nor.eclinicaldirectplus.com",
"affiliation": "N",
"address_1": "50 Central Ave",
"city": "Osseo",
"state": "MN",
"country_code": "US",
"postal_code": "553691241",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Osseo, MN
- Bonita Bolsa Dba Twin Cities Natural Care Center
- Shari Branch, BCTMB
- Bright Future Counseling Services LLC (Bright Future Counseling)
- Chloe Britzius, LICSW
- Lori Ann Brown-de Alba, M.A., LMFT
- Channel of Peace Hospice and Home Health LLC
- Charod Inc (Osseo Gardens Assisted Living)
- Scott Richard Colson, M.D.
- Connect With Massage
- Corner Medical LLC (Corner Home Medical)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.