TIFFANY ANN BRUCKNER D.O.
NPI 1750760070
Pediatrics in Saint Clair Shores, MI
About Tiffany Ann Bruckner D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIFFANY ANN BRUCKNER D.O. (NPI 1750760070) is an individual pediatrics provider in Saint Clair Shores, Michigan, licensed in Michigan (5101021660) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Clinton Township.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tiffany Ann Bruckner D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Tiffany Bruckner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Clinton Township, MI 48038
- Reassigned Medicare billing, Michigan enrollment
- 111 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48081 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT CLAIR SHORES, MI 48081
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 Tiffany Bruckner's NPI number?
The NPI number for Tiffany Bruckner is 1750760070. It was assigned to this individual provider in the NPPES registry on May 19, 2015.
Where is Tiffany Bruckner located?
Tiffany Bruckner practices at 25319 Little Mack Ave, Saint Clair Shores, MI 48081. The listed phone number is (586) 443-4950.
What is Tiffany Bruckner's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Tiffany Bruckner enrolled in Medicare?
Yes. Tiffany Bruckner is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Tiffany Bruckner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tiffany Bruckner reassigns Medicare benefits to Seton Health Corporation Of Southeastern Michigan (Clinton Township, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tiffany Bruckner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tiffany Bruckner accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Tiffany Bruckner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tiffany Bruckner was last updated on May 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Tiffany Ann Bruckner, D.O. · NPI 1750760070
Pediatrics physician in Saint Clair Shores, Michigan. Individual provider, active in the CMS NPPES registry since May 19, 2015.
## Identity
- **NPI:** 1750760070 (Entity type: Individual)
- **Enumerated:** May 19, 2015
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 5101021660 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 25319 LITTLE MACK AVE, Saint Clair Shores, MI 48081-3370
- **Phone:** (586) 443-4950
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Seton Health Corporation Of Southeastern Michigan (NPI 1598177065, Clinton Township, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 1, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1750760070) · Data from the CMS NPPES public registry.