Peter Joseph Bruger, PA C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C03868 Issued in MD

Practice address

5430 Campbell Blvd
Suite 106
White Marsh, MD 21162-5500

Phone

(443) 725-4930

Fax

(443) 725-4933

NPI assigned

Oct 24, 2008

Last updated

Oct 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1780837534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD",
            "address_2": "SUITE 106",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211625500",
            "telephone_number": "443-725-4930",
            "fax_number": "443-725-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD",
            "address_2": "SUITE 106",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211625500",
            "telephone_number": "443-725-4930",
            "fax_number": "443-725-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUGER",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-24",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C03868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in White Marsh, MD
• Providers in White Marsh, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.