Bruce J Andersen MD PHD PA

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

M7767 Issued in ID

Legal business name

BRUCE J ANDERSEN MD PHD PA

Practice address

6140 Curtisian Ave
Suite 400
Boise, ID 83704-8880

Phone

(208) 367-3500

Fax

(208) 367-2968

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Bruce J Andersen, MD PHD

Title

Owner

Phone

(208) 367-3500

Specialties & licenses 1

Addresses

Other identifiers 8

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan G Hart, PA

  • Physician Assistant
  • Boise, ID
  • NPI 1518977826
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1851300503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 CURTISIAN AVE",
            "address_2": "SUITE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048880",
            "telephone_number": "208-367-3500",
            "fax_number": "208-367-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 CURTISIAN AVE",
            "address_2": "SUITE 400",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048880",
            "telephone_number": "208-367-3500",
            "fax_number": "208-367-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE J ANDERSEN MD PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-367-3500",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M7767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "72504",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPARTMENT OF LABOR",
            "identifier": "145403",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805457400",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "134024",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "185529500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010026334",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO GROUP",
            "identifier": "8J703",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87732500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Landon Browning, MD
• Cynthia Lynne Brownsmith, PHD
• Gwen Broyles, RPH
• Brooke Brubaker, BS
• Bruce D.M.D. and Ririe D.D.S., P.a. (Boise Integrative Dentistry)
• Bruce W Hamerl O D P C
• Daniel Bruce, D.D.S.
• Isabel Burns Bruce, BSN-RN
• Jessica Bruce
• Jessica Bruce, LMSW

• Neurological Surgery Physician in Boise, ID
• Providers in Boise, ID by specialty
• Neurological Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.