Individual provider Active NPI

Jeffrey Jon Bruening, DPM

  • Podiatrist
  • Covina, CA
National Provider Identifier
1730264698
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4407 Issued in CA
Practice address
219 W Badillo St
Suite a
Covina, CA 91723-1907
Phone
(626) 915-8777
Fax
(626) 915-8779
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4407 CA Primary

Addresses

Primary practice location

219 W Badillo St
Suite a
Covina, CA 91723-1907

Mailing address

219 W Badillo St
Suite a
Covina, CA 91723-1907
Phone (626) 915-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111028000112 CA Practitioner - Podiatry 5698824803 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bruening Foot and Ankle IncGroup PAC ID 6901079409, 2 clinicians

Practice addresses (Care Compare)

219 W Badillo St
A
Covina, CA 91723-1907
Phone (626) 915-8777

9474 Base Line Rd
Rancho Cucamonga, CA 91701-5822
Phone (909) 987-3211

Hospital & facility affiliations

  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue70
Removal of skin lesions1-10
Removal of nail tissue294
Removal or shaving of skin growth256
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4407CAMDPodiatrist
4407CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bruening Foot and Ankle Inc CurrentSince Aug 13, 2011 Accepting new patients
Vascular Interventional Partners Inc Podiatrist CurrentSince Jan 1, 2021 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Casa Colina Hospital and Centers for Healthcare Past Accepting new patients
Yong Luke Lee Medical Corporation Past Accepting new patients
THC - Orange County, LLC Past Accepting new patients

Locations

219 W Badillo St
Ste A
Covina, CA 91723
Phone (626) 915-8777

9474 Base Line Rd
Rch Cucamonga, CA 91701
Phone (909) 987-0317

18375 Ventura Blvd
Tarzana, CA 91356
Phone (818) 422-5322

935 S Sunset Ave
West Covina, CA 91790
Phone (626) 888-7414

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1730264698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 W BADILLO ST",
            "address_2": "SUITE A",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231907",
            "telephone_number": "626-915-8777",
            "fax_number": "626-915-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W BADILLO ST",
            "address_2": "SUITE A",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231907",
            "telephone_number": "626-915-8777",
            "fax_number": "626-915-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUENING",
        "first_name": "JEFFREY",
        "middle_name": "JON",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.