Individual provider Active NPI

Vanda Bruner, MD

  • Pediatric Adolescent Medicine Physician
  • Holmdel, NJ
National Provider Identifier
1023066305
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
25MA05709800 Issued in NJ
Practice address
719 N Beers St
Suite 1a
Holmdel, NJ 07733-1522
Phone
(732) 264-4646
Fax
(732) 264-4314
NPI assigned
May 5, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 25MA05709800 NJ Primary

Addresses

Primary practice location

719 N Beers St
Suite 1a
Holmdel, NJ 07733-1522

Mailing address

719 N Beers St
Suite 1a
Holmdel, NJ 07733-1522
Phone (732) 264-4646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05709800NJMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vanda Bruner MD PA Adolescent Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023066305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 N BEERS ST",
            "address_2": "SUITE 1A",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331522",
            "telephone_number": "732-264-4646",
            "fax_number": "732-264-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 N BEERS ST",
            "address_2": "SUITE 1A",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331522",
            "telephone_number": "732-264-4646",
            "fax_number": "732-264-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "VANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA05709800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.