| Bruce James Derauf, | |
|
400 E 3rd St, Duluth, MN 55805-1951 | |
| (218) 786-8364 | |
| Not Available |
| Full Name | Bruce James Derauf |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 43 Years |
| Location | 400 E 3rd St, Duluth, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003847385 | NPI | - | NPPES |
| 269300300 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 32484 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Essentia Health Duluth | Duluth, MN | Hospital |
| St Marys Hospital Superior | Superior, WI | Hospital |
| Essentia Health St Mary's Medical Center | Duluth, MN | Hospital |
| Hayward Area Memorial Hospital | Hayward, WI | Hospital |
| Ely Bloomenson Community Hospital | Ely, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Duluth Clinic Ltd | 2567374283 | 957 |
| The Duluth Clinic Ltd | 2567374283 | 957 |
| Entity Name | The Duluth Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902563638 PECOS PAC ID: 2567374283 Enrollment ID: O20031103000229 |
| Entity Name | Brainerd Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295801777 PECOS PAC ID: 0648270272 Enrollment ID: O20070105000140 |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce James Derauf, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 | Bruce James Derauf, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 |
Mrs. Rebecca Lynn Kuntz, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 925 E Superior St, Suite 109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Dr. Matthew Steven Wagner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 | |
Kenneth Dornfeld, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 East 3rd Street, Duluth, MN 55805 Phone: 218-786-8364 | |
Dr. William E. Johnson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 925 E Superior St, Suite109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Dr. Ryan Patrick Wippler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 | |
Michael Edward Ryan, Radiology Medicare: Medicare Enrolled Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 |