Richard Alden Bruno, MD
Individual provider Active NPI Family Medicine Physician · Portland, OR
NPI 1922443191 · NPPES record last updated Oct 14, 2021
Key facts
- NPI
- 1922443191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD0207460 (OR)
- Practice address
- 232 NW 6TH Ave
Portland, OR 97209-3609 - Phone
- (503) 294-1681
- Fax
- (866) 629-0091
- NPI assigned
- May 1, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Oregon Health Sciences University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Multnomah County
Practice addresses (Care Compare)
600 NE 8TH St
Gresham, OR 97030-7317
Phone (503) 988-7468
619 NW 6TH Ave
Portland, OR 97209-3964
Phone (503) 988-7468
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240130003471 | OR | Practitioner - Family Practice | 0042584054 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0083860 | MD | MD | Family Medicine Physician |
| MD0207460 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multnomah County | Current | Accepting new patients | |
| Multnomah County | Current |
Accepting new patients | |
| Mulnomah County | Current |
Accepting new patients | |
| Windber Hospital, Inc. | Past | Accepting new patients |
Locations
600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900
619 NW 6th Ave
Ste 300
Portland, OR 97209
Phone (503) 988-5020
209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674
619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674
Interoperability endpoints
- rbruno689277@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D0083860 | MD | |
| Family Medicine Physician | 207Q00000X | MD0207460 | OR | Yes |
Addresses
Primary practice location
232 NW 6TH Ave
Portland, OR 97209-3609
Mailing address
232 NW 6TH Ave
Portland, OR 97209-3609
Phone (503) 294-1681
NPI Registry JSON
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634169600000",
"number": "1922443191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 NW 6TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093609",
"telephone_number": "503-294-1681",
"fax_number": "866-629-0091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 NW 6TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093609",
"telephone_number": "503-294-1681",
"fax_number": "866-629-0091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNO",
"first_name": "RICHARD",
"middle_name": "ALDEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-01",
"last_updated": "2021-10-14",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0083860",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD0207460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- Brendan Thomas Brunner
- Danielle Theresa Brunner
- Jeffrey Howell Brunner
- Beverly Lynn Bruno
- Justin Womock Bruno
- Rita Bruno
- Sarah E Bruno
- Vicki Ann Bruno
- Jacob Daniel Bruns
- Maureen P Bruns
All providers in Portland, OR · Family Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.