Individual provider Active NPI

Bruce Williams Trotman, MD

  • Gastroenterology Physician
  • Bradenton, FL
National Provider Identifier
1821093576
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME84389 Issued in FL
Practice address
5715 21St Ave W
Bradenton, FL 34208
Phone
(941) 748-1505
Fax
(941) 748-1552
NPI assigned
Jun 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME84389 FL Primary

Addresses

Primary practice location

5715 21St Ave W
Bradenton, FL 34208

Mailing address

5715 21St Ave W #D
Bradenton, FL 34209
Phone (941) 761-1800

Other identifiers 11

IdentifierTypeStateIssuer
78606OtherFLBCBS
5464508OtherFLAETNA
P00149431OtherFLRAIL ROAD MEDICARE
200793285001OtherFLMEDICAL MUTUAL
292062OtherFLAMERIGROUP VA
AA53213OtherFLHARVARD PILGRIM HPHC
226281OtherFLSTAYWELL HEALTHEASE WELLC
7766973OtherFLCIGNA
115965OtherFLHEALTHPARTNERS
271368300MedicaidFL
463979OtherFLAMERIHEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040708000372 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 6305824285 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME84389FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Specialist of Manatee PL Gastroenterology CurrentSince Aug 1, 2004 Accepting new patients
Anesthesia Services of Manatee LLC PastSince May 16, 2021 Accepting new patients

Locations

5715 21st Ave W
#D
Bradenton, FL 34209

5715 21st Ave W
Bradenton, FL 34209
Phone (941) 346-6460

4502 Cortez Rd W
Ste 204
Bradenton, FL 34210
Phone (941) 761-1800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1821093576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 21ST AVE W #D",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34209",
            "telephone_number": "941-761-1800",
            "fax_number": "941-761-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 21ST AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34208",
            "telephone_number": "941-748-1505",
            "fax_number": "941-748-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTMAN",
        "first_name": "BRUCE",
        "middle_name": "WILLIAMS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-18",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME84389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "78606",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5464508",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00149431",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "200793285001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP VA",
            "identifier": "292062",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HPHC",
            "identifier": "AA53213",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL HEALTHEASE WELLC",
            "identifier": "226281",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7766973",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "115965",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271368300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "463979",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.