Elisa Shawn Miller Bruckner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC46893 Issued in NJ

Practice address

205 N Franklin Tpke
Ramsey, NJ 07446-1630

Phone

(201) 321-2956

NPI assigned

Aug 11, 2006

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 NJ

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michael L. Sakowitz PH.D., P.a,

  • Psychologist
  • Wayne, NJ
  • NPI 1952464984
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1043221252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PELZ FARM CT",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303275",
            "telephone_number": "201-321-2956",
            "fax_number": "201-321-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N FRANKLIN TPKE",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461630",
            "telephone_number": "201-321-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER BRUCKNER",
        "first_name": "ELISA",
        "middle_name": "SHAWN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC46893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mid-Atlantic Medical Supply, LLC
• Mid-Atlantic Pathology Services, PA
• Midland Park Internal Medicine Limited Liability Corporation
• Roberta S Migdal, LSW
• Elizabeth Wright Mihatov, LSW
• Mindbody Integrated Care LLC
• Indu Mirchandani, M.D.
• Carolyn M Mitchell, PT
• MJK Medical LLC
• Michelle Molina, MD

• Clinical Social Worker in Ramsey, NJ
• Providers in Ramsey, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.