Individual provider Active NPI

Matthew Ward Bruder

  • Student in an Organized Health Care Education/Training Program
  • La Crosse, WI
National Provider Identifier
1962339937
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1725 State St
La Crosse, WI 54601-3742
Phone
(608) 785-8000
NPI assigned
May 5, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1725 State St
La Crosse, WI 54601-3742

Mailing address

3177 30TH Ave
Elk Mound, WI 54739-4213
Phone (715) 894-7339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1777939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1962339937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3177 30TH AVE",
            "city": "ELK MOUND",
            "state": "WI",
            "postal_code": "547394213",
            "telephone_number": "715-894-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 STATE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013742",
            "telephone_number": "608-785-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDER",
        "first_name": "MATTHEW",
        "middle_name": "WARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-05",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.