Eric J. Bruster, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3597 Issued in WI

Practice address

S74W16775 Janesville Rd
Muskego, WI 53150

Phone

(414) 773-4312

Fax

(414) 422-2188

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Vera French Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bettendorf, IA
  • NPI 1568239978
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1720128523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S74W16775 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531507742",
            "telephone_number": "414-773-4312",
            "fax_number": "414-422-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S74W16775 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "53150",
            "telephone_number": "414-773-4312",
            "fax_number": "414-422-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSTER",
        "first_name": "ERIC",
        "middle_name": "J.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00716",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "00716",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IA",
            "license": "00280",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100083826",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420716337",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Muskego, WI
• Providers in Muskego, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.