Stefan Morales Bruvelis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A2436 Issued in MN

Practice address

1875 19TH St NW
Rochester, MN 55901-1633

Phone

(507) 282-9449

NPI assigned

Dec 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stefan Gunar Bruvelis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1730847666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 CENTER ST W",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559020336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 19TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011633",
            "telephone_number": "507-282-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUVELIS",
        "first_name": "STEFAN",
        "middle_name": "MORALES",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFAN",
            "last_name": "BRUVELIS",
            "middle_name": "GUNAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori K Brundige, APRN, CRNA
• Haley L Bruns, PTA
• Samantha Rose Brunsvold
• Hope Angeline Brus, MD
• William M Brutinel, M.D.
• Erica Bryan-Wegner, MSW
• Brittany Elizabeth Bryant, MD
• Maggie Imelda Bryant, DPT
• Anita J Bryce, NP
• Ethan Scott Bryce, MD

• Physical Therapy Assistant in Rochester, MN
• Providers in Rochester, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.