Individual provider Active NPI

John Michael Brunolli, PT

  • Physical Therapist
  • Sonora, CA
National Provider Identifier
1801810049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 19605 Issued in CA
Practice address
13808 Mono Way
Sonora, CA 95370-8864
Phone
(209) 532-2928
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT 19605 CA Primary

Addresses

Primary practice location

13808 Mono Way
Sonora, CA 95370-8864

Mailing address

22636 Cedar Pines Ave
Twain Harte, CA 95383-9549
Phone (209) 586-8944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111119000035 CA Practitioner - Physical Therapist in Private Practice 0042413460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

850 Sanguinetti Rd
Sonora, CA 95370-5280
Phone (209) 928-5400

Merit-based Incentive Payment System (MIPS)

Final score
47.39 of 100Reported as group
Quality
13.78
Promoting interoperability
0
Improvement activities
40
Cost
81.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 19605CAMDPhysical Therapist
19605CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tuolumne Mewuk Indian Health Center, Inc CurrentSince Dec 28, 2020 Accepting new patients
Tuolumne Me-Wuk Indian Health Center, Inc. CurrentSince Dec 28, 2020 Accepting new patients
Bones Physical Therapy Physical Therapist PastSince Aug 21, 2006 Accepting new patients

Locations

850 Sanguinetti Rd
Sonora, CA 95370
Phone (209) 694-3870

1311 Sanguinetti Rd
Ste C
Sonora, CA 95370
Phone (209) 928-5400

18352 Tuolumne Rd
Ste 7
Tuolumne, CA 95379

18880 Cherry Valley Blvd
Tuolumne, CA 95379
Phone (209) 928-5400

Interoperability endpoints

  • Direct secure messaging: john.brunolli.p1@direct.tmwihc.nextgenshare.com

Organizations & group practices 3

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801810049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22636 CEDAR PINES AVE",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953839549",
            "telephone_number": "209-586-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13808 MONO WAY",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953708864",
            "telephone_number": "209-532-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNOLLI",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 19605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.