Individual provider Active NPI

Dustin M Bronsdon, AU.D.

  • Audiologist
  • Portland, OR
National Provider Identifier
1851726319
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
30783 Issued in OR
Practice address
2222 NW Lovejoy St
607
Portland, OR 97210-3033
Phone
(503) 222-3638
NPI assigned
Sep 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 30783 OR Primary

Addresses

Primary practice location

2222 NW Lovejoy St
607
Portland, OR 97210-3033

Mailing address

9532 SW 52ND Ave
Portland, OR 97219-5041
Phone (715) 797-3021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140116001746 OR Practitioner - Qualified Audiologist 9537397690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Wisconsin School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Associates LLCGroup PAC ID 3779884820, 4 clinicians

Practice addresses (Care Compare)

900 SE Oak St
Suite 201
Hillsboro, OR 97123-4287
Phone (503) 648-8971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30783ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose and Throat Associates, LLC. CurrentSince Sep 1, 2023 Accepting new patients

Locations

900 SE Oak St
Ste 201
Hillsboro, OR 97123
Phone (503) 648-8971

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1851726319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9532 SW 52ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195041",
            "telephone_number": "715-797-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "607",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103033",
            "telephone_number": "503-222-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONSDON",
        "first_name": "DUSTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "30783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.