Individual provider Active NPI

Ethan Bruno, DPT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1790674901
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65774 Issued in OR
Practice address
915 NE 7TH St Ste 1
Bend, OR 97701-4515
Phone
(541) 728-0974
Fax
(541) 728-0159
NPI assigned
Jul 1, 2025
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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 65774 OR Primary

Addresses

Primary practice location

915 NE 7TH St Ste 1
Bend, OR 97701-4515

Mailing address

915 NE 7TH St Ste 1
Bend, OR 97701-4515
Phone (541) 728-0974

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251030002474 OR Practitioner - Physical Therapist in Private Practice 1355830225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resolve Physical TherapyGroup PAC ID 5991042616, 7 clinicians

Practice addresses (Care Compare)

1740 NW Pence LN
Suite 5
Bend, OR 97703-6743
Phone (541) 306-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65774ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Resolve Physical Therapy Physical Therapist CurrentSince Sep 30, 2025 Accepting new patients
Compass Physical Therapy LLC Physical Therapist CurrentSince Jul 9, 2025 Accepting new patients

Locations

1740 NW Pence Ln
Ste 5
Bend, OR 97703
Phone (541) 306-1099

915 NE 7th St
Ste 1
Bend, OR 97701
Phone (541) 728-0974

Organizations & group practices 2

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1790674901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 NE 7TH ST STE 1",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014515",
            "telephone_number": "541-728-0974",
            "fax_number": "541-728-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 NE 7TH ST STE 1",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014515",
            "telephone_number": "541-728-0974",
            "fax_number": "541-728-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "ETHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.