DR. TIMOTHY BRUNELLE - NPI 1225488349 - Clinical Neuropsychologist in Boulder, CO

Q: What is Timothy Brunelle's NPI number?

The NPI number for Timothy Brunelle is 1225488349. It was assigned to this individual provider in the NPPES registry on June 20, 2016.

Q: What is Timothy Brunelle's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Brunelle was last updated on January 31, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Timothy Brunelle NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIMOTHY BRUNELLE (NPI 1225488349) is an individual clinical neuropsychologist in Boulder, Colorado, licensed in Colorado (5524) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225488349

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameDR. TIMOTHY BRUNELLE

Location Address255 CANYON BLVD STE 200Boulder, CO 80302-4954

Mailing Address255 Canyon Blvd Ste 200Boulder, CO 80302-4954 · (720) 744-0577 · Fax (720) 638-3699

Phone(720) 744-0577

Sole ProprietorYes

Enumeration DateJune 20, 2016

Last NPPES UpdateJanuary 31, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 31, 2022

✔ NPI 1225488349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in CO · 5524

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

255 CANYON BLVD STE 200, Boulder, CO 80302

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy Brunelle is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HALEY MILLER PSY.D.

Psychologist (Clinical)