Dr Kimberly Ann Bruno-de La Mata, MD - Medicare Emergency Medicine in Windermere, FL

  1. Home
  2. Emergency Medicine
  3. FL
  4. Windermere
Dr Kimberly Ann Bruno-de La Mata, MD is a medicare enrolled "Emergency Medicine" physician in Windermere, Florida. Her current practice location is 13506 Summerport Village Pkwy, #341, Windermere, Florida. You can reach out to her office (for appointments etc.) via phone at (865) 363-3330.

Dr Kimberly Ann Bruno-de La Mata is licensed to practice in Florida (license number ME101735) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1548216419.

Contact Information

Dr Kimberly Ann Bruno-de La Mata, MD
13506 Summerport Village Pkwy, #341,
Windermere, FL 34786-7366
(865) 363-3330
Not Available

Map and Direction




Physician's Profile

Full NameDr Kimberly Ann Bruno-de La Mata
GenderFemale
SpecialityEmergency Medicine
Location13506 Summerport Village Pkwy, Windermere, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1548216419
  • Provider Enumeration Date: 05/25/2006
  • Last Update Date: 12/11/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5395775035
  • Enrollment ID: I20050812000771

Medical Identifiers

Medical identifiers for Dr Kimberly Ann Bruno-de La Mata such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548216419NPI-NPPES
3856126MedicaidTN
4103352OtherTNBLUE CROSS
P00284603OtherTNRRGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine ME101735 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kimberly Ann Bruno-de La Mata allows following entities to bill medicare on her behalf.
Entity NameTri-cities Regional Emergency Physicians, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063950046
PECOS PAC ID: 3678859477
Enrollment ID: O20170410002399
Entity NameApp Of East Tennessee Ed Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326695537
PECOS PAC ID: 6800127796
Enrollment ID: O20191007003318

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kimberly Ann Bruno-de La Mata is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Kimberly Ann Bruno-de La Mata, MD
1200 J D Anderson Dr,
Morgantown, WV 26505-3494

Ph: (304) 598-1200		Dr Kimberly Ann Bruno-de La Mata, MD
13506 Summerport Village Pkwy, #341,
Windermere, FL 34786-7366

Ph: (865) 363-3330

Reviews and Comments


Emergency Medicine Doctors in Windermere, FL

Dr. Mariano De La Mata, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 13506 Summerport Village Pkwy, #341, Windermere, FL 34786
Phone: 865-406-9069    
Dr. Brian Wiboon, DO
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 5143 Tildens Grove Blvd, Windermere, FL 34786
Phone: 407-656-9908    Fax: 407-656-9908

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.