Tiffany Bruckner, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CP000859 Issued in SD

Practice address

201 S Lloyd St Ste E201
Aberdeen, SD 57401-4509

Phone

(605) 622-2545

Fax

(605) 229-5331

NPI assigned

Jun 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tiffany Moore Former name

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera St Lukes Hospital, Aberdeen, SD, CCN 430014
• Community Memorial Hospital Hospital, Redfield, SD, CCN 431316
• Bowdle Hospital - Cah Hospital, Bowdle, SD, CCN 431318
• Eureka Community Health Services - Cah Hospital, Eureka, SD, CCN 431308
• Avera Hand County Memorial Hospital and Clinic Hospital, Miller, SD, CCN 431337

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tiffany.bruckner@avera.sdhealthlink.net

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.

• Avera St. Luke'S

  • Internal Medicine Physician
  • Aberdeen, SD
  • NPI 1215100813
  Medicare reassignment Care Compare group NPD
• Avera St Lukes

  • Psychiatric Hospital Unit
  • Aberdeen, SD
  • NPI 1003867029
  NPD
• Avera St. Lukes

  • Nephrology Physician
  • Aberdeen, SD
  • NPI 1477594430
  NPD
• Avera St Lukes

  • Rural Health Clinic/Center
  • Ellendale, ND
  • NPI 1760423057
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Avera McKennan

  • Critical Access Hospital
  • Miller, SD
  • NPI 1922277060
  Care Compare affiliation
• Avera St Lukes

  • General Acute Care Hospital
  • Aberdeen, SD
  • NPI 1457309270
  Care Compare affiliation
• Bowdle Hospital

  • Critical Access Hospital
  • Bowdle, SD
  • NPI 1669418877
  Care Compare affiliation
• City of Redfield

  • Critical Access Hospital
  • Redfield, SD
  • NPI 1548232747
  Care Compare affiliation
• City of Redfield

  • Critical Access Hospital
  • Redfield, SD
  • NPI 1871565853
  Care Compare affiliation
• City of Redfield

  • Ambulance
  • Redfield, SD
  • NPI 1881666444

  Hospital

  Care Compare affiliation
• Eureka Community & Benevolent Hospital

  • Critical Access Hospital
  • Eureka, SD
  • NPI 1629152749
  Care Compare affiliation

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1801201439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574021460",
            "telephone_number": "605-622-2857",
            "fax_number": "605-622-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S LLOYD ST STE E201",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014509",
            "telephone_number": "605-622-2545",
            "fax_number": "605-229-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "TIFFANY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP000859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "MOORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly M Brennan, PT
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• Melissa R Brown, M.D.
• Tomee Brown
• Jenelle Brunson, RBT
• Amber Rae Bryant, ATC
• Kari Jean Buisker, PT
• Kristi Burckhard
• Paiton Burckhard

• Nurse Practitioner in Aberdeen, SD
• Providers in Aberdeen, SD by specialty
• Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.