MARY E BRUCE (PA) – Surgical Physician Assistant, NPI 1508974700
Surgical Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for MARY E BRUCE (PA)
1407, Union Avenue, Annesdale Park, Memphis, Shelby County, Tennessee, 38104, United States
SUITE 700
MEMPHIS, TN 381043627
Phone: (901) 448-2579
Fax: (901) 302-2480
Type: Mailing
1 PERKINS SQ
AKRON, OH 443081063
Phone: (330) 543-8224
Fax: (330) 543-3648
Type: Location
890, Madison Avenue, Medical District, Dixie Homes, Memphis, Shelby County, Tennessee, 38103, United States
MEMPHIS, TN 381033409
Phone: (901) 448-2579
Fax: (901) 302-2480
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $473.
Total Amount is formed as General ($473) + Research ($0) + Ownership ($0) = $473.
Last reported payment date: 2024-04-18 • Largest payer in this snapshot: PolyNovo North America LLC ($439).
Total Amount
$473
General + Research + Ownership
Payments
4
Total payment records
General Amount
$473
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PolyNovo North America LLC | $439 |
| Avita Medical Americas, Llc | $34 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-03-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210310003008 | I | Physician Assistant | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 38104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| - | OH | |
| Nurse Practitioner | OH | |
| Pulmonary Disease | OH | |
| - | OH | |
| - | OH | |
| Pediatric Medicine, Endocrinology | OH | |
| - | OH | |
| - | OH | |
| - | OH |
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