NPIMap

Individual provider Active NPI

Chelsea E Bruns, PA

  • Physician Assistant
  • Midland, MI
National Provider Identifier
1871003145
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008445 Issued in MI
Practice address
555 W Wackerly St Ste 1600
Midland, MI 48640
Phone
(989) 631-9515
Fax
(989) 839-8817
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008445 MI Primary

Addresses

Primary practice location

555 W Wackerly St Ste 1600
Midland, MI 48640

Mailing address

555 W Wackerly St Ste 1600
Midland, MI 48640-2745
Phone (989) 631-9515

Other practice location 1

555 W Wackerly St Ste 1600
Midland, MI 48640
Phone (989) 631-9515

Other names 1

  • Chelsea E Dull Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013002719 MI Practitioner - Physician Assistant 5193090355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians
Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

2325 Rockwell Dr
Midland, MI 48642-9325
Phone (989) 898-9664

5785 E Broadway Rd
Mt Pleasant, MI 48858-8987
Phone (989) 773-9421

Hospital & facility affiliations

  • Mymichigan Home Care Home health agency, Midland, MI, CCN 237015
  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180
  • Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601008445MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Group CurrentSince Jul 1, 2020 Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

Interoperability endpoints

  • Direct secure messaging: cbruns66723@mymichiganhealth.midirect.net

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1871003145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST STE 1600",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402745",
            "telephone_number": "989-631-9515",
            "fax_number": "989-839-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST STE 1600",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-631-9515",
            "fax_number": "989-839-8817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 W Wackerly St Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "48640",
            "country_code": "US",
            "telephone_number": "989-631-9515",
            "fax_number": "989-839-8817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "CHELSEA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "DULL",
            "middle_name": "E",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.