NPIMap

Individual provider Active NPI

Bruce W Dennis, MD

  • Internal Medicine Physician
  • Ada, OK
National Provider Identifier
1760450555
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18405 Issued in OK
Practice address
721 Better Now PLZ
Ada, OK 74820-2279
Phone
(580) 272-0025
Fax
(580) 272-6559
NPI assigned
Mar 9, 2006
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18405 OK Primary

Addresses

Primary practice location

721 Better Now PLZ
Ada, OK 74820-2279

Mailing address

902 Arlington Ctr
PMB 224
Ada, OK 74820-2883
Phone (580) 272-0025

Other identifiers 1

IdentifierTypeStateIssuer
18405OtherOKMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040511000258 OK Practitioner - Internal Medicine 7416945357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bruce W Dennis MD PLLCGroup PAC ID 7517955453, 3 clinicians

Practice addresses (Care Compare)

721 Better Now PLZ
Ada, OK 74820-2279
Phone (580) 272-0025

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18405OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce W Dennis MD PLLC Internal Medicine CurrentSince Apr 1, 2002 Accepting new patients
McCall's Chapel School Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients
McCall's Chapel School Inc Past Accepting new patients
McCall's Chapel School Inc Past Accepting new patients

Locations

325 N Monte Vista St
Ada, OK 74820
Phone (580) 272-0025

3012 Arlington St
Ada, OK 74820
Phone (580) 272-0715

721 Better Now Plz
Ada, OK 74820
Phone (580) 272-0025

902 Arlington Ctr
Ada, OK 74820
Phone (580) 310-2513

301 N Monte Vista St
Ada, OK 74820
Phone (580) 436-2262

Organizations & group practices 5

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 9

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1760450555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 ARLINGTON CTR",
            "address_2": "PMB 224",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202883",
            "telephone_number": "580-272-0025",
            "fax_number": "580-272-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 BETTER NOW PLZ",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202279",
            "telephone_number": "580-272-0025",
            "fax_number": "580-272-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "BRUCE",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "18405",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.