Stephani Louise Bruyer, M.A.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3669 Issued in MN

Practice address

1603 W Old Shakopee Rd
Bloomington, MN 55431-3065

Phone

(952) 767-3680

Fax

(952) 767-0018

NPI assigned

Jul 25, 2007

Sex

Female

Sole proprietor

Yes

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Abintra Inc.Group PAC ID 0345589859, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Abintra, Inc

  • Clinical Social Worker
  • Bloomington, MN
  • NPI 1518412907
  Medicare reassignment Care Compare group NPD
• Southern Cities Clinic

  • General Practice Physician
  • Faribault, MN
  • NPI 1437218740
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1790975928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18986 LAKE DR E",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179348",
            "telephone_number": "952-474-5974",
            "fax_number": "952-474-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 W OLD SHAKOPEE RD",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313065",
            "telephone_number": "952-767-3680",
            "fax_number": "952-767-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUYER",
        "first_name": "STEPHANI",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Brownell, DC
• Annika Bruestle
• Ashley Nicole Bruggeman
• Connie Bruhn
• Dillon Bruxvoort
• Mark Buboltz, O.D.
• Beverly Denise Buchanan, M.A., LMFT, LADC
• Kiley Buchanan
• Michelle Kaju Buchl, LADC
• Ryan Buchmeier

• Psychologist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.