BRUCE BROKAW (NPI# 1316159072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316159072 |
| Entity Type | Individual |
| Full Name | BRUCE BROKAW |
| Credential | P.A.-C. |
| Practice Address |
400 Captain Thomas Road Wells ME 04090-7552 |
| Mailing Address |
400 Captain Thomas Rd Wells Maine ME 04090 |
| Practice Telephone | 6037403293 |
| Mailing Telephone | 6037403293 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0170 | NH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
400 CAPTAIN THOMAS ROAD |
| City | WELLS |
| State | ME |
| Zip Code | 04090-7552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891239679 | Avita Wells LLC | Alzheimer Center (Dementia Center) | 86 Sanford Road, Wells, ME 04090 | 2016-12-13 |
| 1588811699 | Cvs State Capital, L.L.C. | Durable Medical Equipment & Medical Supplies | 11 Steeple Way, Wells, ME 04090 | 2008-08-20 |
| 1235322561 | Gregory Evan Thibeault | Physical Therapist | 112 Sanfor Road (rt. 109), Wells Physical Therapy, Wells, ME 04090 | 2007-08-21 |
| 1962604496 | Elizabeth Marie Anderson | Physical Therapist | 57 Cranberry St, Wells, ME 04090 | 2007-06-05 |
| 1285856146 | Sandra Lee Cionni | Speech-Language Pathologist | 867 Cheney Woods Road, Wells, ME 04090 | 2007-05-02 |
| 1265651814 | Wells Ogunquit Community School District | Local Education Agency (LEA) | 1460 Post Road, Wells, ME 04090 | 2007-04-24 |
| 1164649174 | Jus Crea Andrea Giammarino | Preventive Medicine | 1239 Post Road, Wells, ME 04090 | 2007-04-19 |
| 1104902188 | Caren Klein | Social Worker | 43 Sanford Rd, Wells, ME 04090 | 2006-10-31 |
| 1184700155 | Douglas Stephen Merrill | Chiropractor | 2550 Post Road, Wells, ME 04090 | 2006-10-31 |
| 1699860270 | York Hospital Dba Coastal Ob-gyn, LLC | Obstetrics & Gynecology | 112 Sanford Road, Suite 2a, Wells, ME 04090 | 2006-10-03 |
| Find all providers in zip 04090 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1073081428 | Ishah Marie Price | Physician Assistant | 30 Preble St Apt 663, Portland, ME 04101-4939 | 2018-11-04 |
| 1073056412 | Sara Burdick | Physician Assistant | 9 Healthcare Dr Ste 202, Biddeford, ME 04005-9450 | 2016-12-01 |
| 1487068565 | Andrew Cutter | Physician Assistant | 31 Annies Way, Gorham, ME 04038-2391 | 2014-06-17 |
| 1629337902 | Shannon N Moreau | Physician Assistant | 343 Us Route 1, York, ME 03909-1636 | 2012-05-08 |
| 1366769085 | David Arthur Hamel | Physician Assistant | 85 Brixham Rd, York, ME 03909-5342 | 2010-04-21 |
| 1164751152 | Elaine M Cadorette | Physician Assistant | 100 Foden Rd., West Building Suite 103, South Portland, ME 04106-2351 | 2009-12-22 |
| 1316130198 | Ronald W Kessler | Physician Assistant | 632 Brighton Ave, Portland, ME 04102-1017 | 2007-08-24 |
| 1932300142 | Ian Fm Buchan | Physician Assistant | Central Maine Partners In Health, 30 Belgrade Avenue, Auburn, ME 04210 | 2007-05-29 |
| 1780747519 | Wendy Brown Jorgensen | Physician Assistant | 1053 Western Avenue, Manchester, ME 04351 | 2006-12-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.