Bradenton East Medical PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BRADENTON EAST MEDICAL PA

Practice address

6120 53Rd Ave E
Bradenton, FL 34203-9707

Phone

(941) 727-1243

NPI assigned

Oct 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Elsy Rucker, M.D.NPI 1265422430

Title

President

Phone

(941) 727-1243

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Elsy Rucker, M.D.

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1265422430
  NPD (past) Authorized official

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861589467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342039707",
            "telephone_number": "941-727-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342039707",
            "telephone_number": "941-727-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADENTON EAST MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "ELSY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-727-1243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FLORIDA GROUP NUMBER",
            "identifier": "21621",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradenton Council on Aging LLC (Riverfront Nursing and Rehabilitation Center)
• Bradenton Counseling Center, Inc.
• Bradenton Dialysis Center LLC
• Bradenton East Integrative Medicine
• Bradenton East Integrative Medicine
• Bradenton Endocrinology, PA
• Bradenton Enterprise LLC (Braden River Care Center)
• Bradenton Eye Clinic Inc
• Bradenton Gastroenterology PA
• Bradenton Geriatrics LLC

• Family Medicine Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.