Individual provider Active NPI

Venita Wiegand Bruss, P.T.

  • Physical Therapist
  • Port Orchard, WA
National Provider Identifier
1750718722
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00010306 Issued in WA
Practice address
463 Tremont St W Ste 100
Port Orchard, WA 98366-3743
Phone
(360) 784-0745
NPI assigned
Oct 4, 2013
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00010306 WA Primary

Addresses

Primary practice location

463 Tremont St W Ste 100
Port Orchard, WA 98366-3743

Mailing address

463 Tremont St W Ste 100
Port Orchard, WA 98366-3743
Phone (708) 571-6498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206001467 WA Practitioner - Physical Therapist in Private Practice 4385170844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kitsap Physical Therapy and Sports Clinic PS IncGroup PAC ID 6507762333, shared by 5 NPIs, 142 clinicians

Practice addresses (Care Compare)

1880 Pottery Ave
Suite 100
Port Orchard, WA 98366-2518
Phone (360) 895-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00010306WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates, Inc. Physical Therapist Current Accepting new patients
Physiotherapy Associates Inc CurrentSince Nov 7, 2024 Accepting new patients
Physiotherapy Associates, Inc. CurrentSince Nov 7, 2024 Accepting new patients

Locations

463 Tremont St W
Ste 100
Port Orchard, WA 98366
Phone (360) 874-0745

23515 NE Novelty Hill Rd
Ste B213
Redmond, WA 98053
Phone (425) 868-5260

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1750718722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 TREMONT ST W STE 100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663743",
            "telephone_number": "708-571-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 TREMONT ST W STE 100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663743",
            "telephone_number": "360-784-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGAND BRUSS",
        "first_name": "VENITA",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-04",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "00010306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.