Active NPI
Clinton Bruck, FNP-BC
- Nurse Practitioner
- Pittsburgh, PA
National Provider Identifier
1053135806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP031278
- Practice address
- 400 Mosites Way Ste 401
Pittsburgh, PA 15205-1342 - Phone
- (412) 235-3256
- NPI assigned
- Nov 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP031278 | PA | Primary |
Addresses
Primary practice location
400 Mosites Way Ste 401
Pittsburgh, PA 15205-1342
Mailing address
400 Mosites Way Ste 401
Pittsburgh, PA 15205-1342
Phone (412) 235-3256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250117001457 | PA | Order and Referring Only - Nurse Practitioner | 2961931068 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759190400000",
"number": "1053135806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 MOSITES WAY STE 401",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152051342",
"telephone_number": "412-235-3256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 MOSITES WAY STE 401",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152051342",
"telephone_number": "412-235-3256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCK",
"first_name": "CLINTON",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-08",
"last_updated": "2025-09-30",
"certification_date": "2025-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP031278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.