Individual provider Active NPI

Matthew James Bruha, MD

  • Urology Physician
  • Lakeland, FL
National Provider Identifier
1750887907
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME171916 Issued in FL
Practice address
4715 S Florida Ave
Lakeland, FL 33813-2126
Phone
(863) 209-7004
NPI assigned
Apr 4, 2018
Last updated
Jul 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME171916 FL Primary

Addresses

Primary practice location

4715 S Florida Ave
Lakeland, FL 33813-2126

Mailing address

702 N Alexander St
Plant City, FL 33563-3064
Phone (813) 722-8746

Other practice location 1

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Other practice location 2

702 N Alexander St
Plant City, FL 33563-3064
Phone (813) 722-8746

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbruha28925@direct.watsonclinicad.com Watson Clinic LLP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221222001940 NY Practitioner - Urology 3274903885 Reassigns benefits to 2 organizations
I20250514001781 FL Practitioner - Urology 3274903885 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Albany Medical College of Union University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Medicine IncGroup PAC ID 4880756204, 4 clinicians

Practice addresses (Care Compare)

541 S Florida Ave
Lakeland, FL 33801-5228
Phone (863) 682-7246

702 N Alexander St
Plant City, FL 33563-3064
Phone (813) 722-8746

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME171916FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
E & E Family LLC Urology CurrentSince Nov 5, 2025 Accepting new patients
Pain Medicine Inc Urology CurrentSince Apr 1, 2025 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Dec 1, 2022 Accepting new patients
TBHC Physician Services PC CurrentSince Mar 1, 2023 Accepting new patients
Lakeland FL Endoscopy ASC LLC CurrentSince Sep 1, 2025 Accepting new patients
Brooklyn Hospital Radiology P C PastSince Mar 1, 2023 Accepting new patients

Locations

202 Parkview Pl
Lakeland, FL 33805
Phone (863) 682-6686

3340 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (407) 451-5099

541 S Florida Ave
Lakeland, FL 33801
Phone (863) 682-3239

702 N Alexander St
Plant City, FL 33563
Phone (813) 722-8746

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

175 Remsen St
Fl 12
Brooklyn, NY 11201

86 Saint Felix St
Fl 7
Brooklyn, NY 11217
Phone (212) 379-6414

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

1 Research Rd
Ridge, NY 11961

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mbruha17675@prd.direct.tbh.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1750887907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N ALEXANDER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335633064",
            "telephone_number": "813-722-8746",
            "fax_number": "863-682-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132126",
            "telephone_number": "863-209-7004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338053019",
            "country_code": "US",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 N Alexander St",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335633064",
            "country_code": "US",
            "telephone_number": "813-722-8746",
            "fax_number": "863-682-5566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUHA",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME171916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbruha28925@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.