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BRUCE TANNER SEIBOLD MD
NPI 1629918453
Student in an Organized Health Care Education/Training Program in Worcester, MA

Active since March 31, 2026PECOS Enrolled
55 LAKE AVE N, WORCESTER, MA 01655(508) 334-1000 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Bruce Tanner Seibold Md NPPES

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

BRUCE TANNER SEIBOLD MD (NPI 1629918453) is an individual student in an organized health care education/training program in Worcester, Massachusetts and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629918453
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBRUCE TANNER SEIBOLDCredential: MD
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing Address55 Lake Ave NWorcester, MA 01655-0002 · (508) 334-1000
Phone(508) 334-1000
Sole ProprietorNo
Enumeration DateMarch 31, 2026
NPPES CertifiedMarch 31, 2026
✔ NPI 1629918453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
55 LAKE AVE N, Worcester, MA 01655
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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)

Bruce Tanner Seibold Md 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 20

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

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
YOONYIE CHO M.D.
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Seibold's NPI number?

The NPI number for Bruce Seibold is 1629918453. It was assigned to this individual provider in the NPPES registry on March 31, 2026.

Where is Bruce Seibold located?

Bruce Seibold practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-1000.

What is Bruce Seibold's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Bruce Seibold enrolled in Medicare?

Yes. Bruce Seibold is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bruce Seibold was last updated on March 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.