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MR. BRUCE ALAN CAVANAUGH PA-C
NPI 1689633414
Physician Assistant - Medical in Woodstock, MD

Active since March 21, 2006PECOS Enrolled
9987 VILLAGE GREEN DR, WOODSTOCK, MD 21163(443) 570-2782(443) 570-2782 Get Directions Write a Review

NPPES record last updated: April 13, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Bruce Alan Cavanaugh Pa-c NPPES

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

MR. BRUCE ALAN CAVANAUGH PA-C (NPI 1689633414) is an individual medical provider in Woodstock, Maryland, licensed in Maryland (C002022) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689633414
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. BRUCE ALAN CAVANAUGHCredential: PA-C
Location Address9987 VILLAGE GREEN DRWoodstock, MD 21163-1155
Mailing Address9987 Village Green DrWoodstock, MD 21163-1155 · (443) 570-2782 · Fax (443) 570-2782
Phone(443) 570-2782
Fax(443) 570-2782
Sole ProprietorNo
Enumeration DateMarch 21, 2006
Last NPPES UpdateApril 13, 2016
✔ NPI 1689633414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MD · C002022
Also ListedPhysician AssistantTaxonomy 363A00000X · License C002022 (MD)
9987 VILLAGE GREEN DR, Woodstock, MD 21163
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Other Identifiers 4

Medicare PINKL09P096MD
Medicare PINP09559MD
Medicare PINKL33P095MD
Medicare PINKL19P094MD

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Bruce Alan Cavanaugh Pa-c 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.

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 Cavanaugh's NPI number?

The NPI number for Bruce Cavanaugh is 1689633414. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Where is Bruce Cavanaugh located?

Bruce Cavanaugh practices at 9987 Village Green Dr, Woodstock, MD 21163. The listed phone number is (443) 570-2782.

What is Bruce Cavanaugh's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Bruce Cavanaugh enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Bruce Cavanaugh was last updated on April 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.