Jennifer Brungardt, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

109064-01 Issued in NY

Practice address

5050 Iselin Ave
Bronx, NY 10471-2915

Phone

(718) 549-6700

NPI assigned

Jul 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Thaxton Holistic Wellness Center

  • Professional Counselor
  • Scranton, PA
  • NPI 1609243898
  Medicare reassignment Care Compare group NPD
• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1023636438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 E 134TH ST APT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104544528",
            "telephone_number": "917-573-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 ISELIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712915",
            "telephone_number": "718-549-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNGARDT",
        "first_name": "JENNIFER",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109064-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Bruder
• Allison Brudner
• Rachel Jill Brugger, FNP
• Dominic B Brunello, MD
• Solaika Brunet
• Colette Bruni, DO
• Kathryn J Bruning
• Antoine Bruno, LPN
• Hilary Ashley Bruno, MSW
• Kevin Bruno, LPN

• Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.