Active NPI
Wayne Edward Brunell, MD
- Psychiatry Physician
- Cambridge, MA
National Provider Identifier
1740282094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 150121
- Practice address
- 872 Massachusetts Ave
Ste 1-4
Cambridge, MA 02139-3013 - Phone
- (617) 234-4405
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 150121 | MA | Primary |
Addresses
Primary practice location
872 Massachusetts Ave
Ste 1-4
Cambridge, MA 02139-3013
Mailing address
872 Massachusetts Ave
Ste 1-4
Cambridge, MA 02139-3013
Phone (617) 234-4405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284076800000",
"number": "1740282094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "872 MASSACHUSETTS AVE",
"address_2": "STE 1-4",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021393013",
"telephone_number": "617-234-4405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "872 MASSACHUSETTS AVE",
"address_2": "STE 1-4",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021393013",
"telephone_number": "617-234-4405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNELL",
"first_name": "WAYNE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2010-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "150121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.