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TIFFANY ANN BRUCKNER D.O.
NPI 1750760070
Pediatrics in Saint Clair Shores, MI

Active since May 19, 2015PECOS Enrolled
25319 LITTLE MACK AVE, SAINT CLAIR SHORES, MI 48081(586) 443-4950 Get Directions Write a Review

NPPES record last updated: May 1, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 1, 2023, Jun 28, 2018, Feb 27, 2018 (3 updates tracked since 2018).

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

NPI1750760070
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameTIFFANY ANN BRUCKNERCredential: D.O.
Location Address25319 LITTLE MACK AVESaint Clair Shores, MI 48081-3370
Mailing Address25319 Little Mack AveSaint Clair Shores, MI 48081-3370 · (586) 443-4950
Phone(586) 443-4950
Sole ProprietorYes
Enumeration DateMay 19, 2015
Last NPPES UpdateMay 1, 20233 updates tracked since enumeration
NPPES CertifiedMay 1, 2023
✔ NPI 1750760070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 5101021660
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
25319 LITTLE MACK AVE, Saint Clair Shores, MI 48081
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Secondary Practice Location 1

Location 136075 Utica Rd Ste 100Clinton Township, MI 48035-1061 · Phone (586) 741-0430

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tiffany Ann Bruckner D.o. 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.

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.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

WAFAA S. HANNA M.D.
Internal Medicine
25319 LITTLE MACK AVE
ST CLAIR SHORES, MI 48081
Macomb County (586) 447-4000
LYLA J LEIPZIG M.D.
Internal Medicine
25319 LITTLE MACK AVE
ST CLAIR SHORES, MI 48081
Macomb County (586) 447-4000
TANJEEN CHOWDHURY M.D.
Internal Medicine
25319 LITTLE MACK AVE
ST CLAIR SHORES, MI 48081
Macomb County (586) 447-4000
DR. KEVIN J GRADY M.D.
Internal Medicine (Pulmonary Disease)
25319 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48081
Macomb County (586) 772-5550
MARIE F ABIRAGI M.D.
Internal Medicine
25319 LITTLE MACK AVE
ST CLAIR SHORES, MI 48081
Macomb County (586) 447-4000

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.

What insurance does Tiffany Bruckner accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health 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 with the weekly NPPES data releases published by CMS.