Active NPI
M Jean Bruce, MD
- Surgery Physician
- Berlin, WI
National Provider Identifier
1962403832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 28491-020
- Practice address
- 225 Memorial Dr
Suite 1200
Berlin, WI 54923-1243 - Phone
- (920) 361-5770
- Fax
- (920) 361-5779
- NPI assigned
- Aug 2, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 28491-020 | WI | |
| Surgery Physician | 208600000X | 28491-020 | WI | Primary |
Addresses
Primary practice location
225 Memorial Dr
Suite 1200
Berlin, WI 54923-1243
Mailing address
225 Memorial Dr
Berlin, WI 54923-1243
Phone (920) 361-1313
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31507600 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28491-020 | WI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1962403832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 MEMORIAL DR",
"city": "BERLIN",
"state": "WI",
"postal_code": "549231243",
"telephone_number": "920-361-1313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MEMORIAL DR",
"address_2": "SUITE 1200",
"city": "BERLIN",
"state": "WI",
"postal_code": "549231243",
"telephone_number": "920-361-5770",
"fax_number": "920-361-5779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "M",
"middle_name": "JEAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "28491-020",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "28491-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31507600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.