Individual provider Active NPI

Allison J Brucker, M.D.

  • Ophthalmology Physician
  • Phialdelphia, PA
National Provider Identifier
1790718245
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD436479 Issued in PA
Practice address
51 N/ 39TH Street
Scheie Eye Institute
Phialdelphia, PA 19104
Phone
(215) 662-8100
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 233958 NY
Ophthalmology Physician 207W00000X MD436479 PA Primary

Addresses

Primary practice location

51 N/ 39TH Street
Scheie Eye Institute
Phialdelphia, PA 19104

Mailing address

51 N. 39TH Street
Scheie Eye Institute
Phialdelphia, PA 19104
Phone (215) 662-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111005000091 PA Practitioner - Ophthalmology 4688770712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Perelman School of Med at the University of Pennsylvania, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-8100

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD436479PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Ophthalmology CurrentSince Jun 13, 2018 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Mitsugu Shimmyo, MD PC Ophthalmology Past Accepting new patients

Locations

3400 Civic Center Blvd
#3W
Philadelphia, PA 19104
Phone (215) 615-0063

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1790718245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N. 39TH STREET",
            "address_2": "SCHEIE EYE INSTITUTE",
            "city": "PHIALDELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N/ 39TH STREET",
            "address_2": "SCHEIE EYE INSTITUTE",
            "city": "PHIALDELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKER",
        "first_name": "ALLISON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "233958",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD436479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phialdelphia, PA

Sources for this page

Verify at the official NPI Registry.