Nicholas Paul Bruno, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

5860 Issued in RI

Practice address

3 Wake Robin Rd Unit 5
Lincoln, RI 02865-4208

Phone

(401) 475-9140

Fax

(401) 475-2808

NPI assigned

Sep 5, 2006

Last updated

Apr 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rhode Island Dermatology Obs

  • Ambulatory Surgical Clinic/Center
  • Lincoln, RI
  • NPI 1235202201
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1053413484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 SMITH STREET",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083592",
            "telephone_number": "401-421-7656",
            "fax_number": "401-270-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WAKE ROBIN RD UNIT 5",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654208",
            "telephone_number": "401-475-9140",
            "fax_number": "401-475-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "NICHOLAS",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "5860",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "RI",
            "license": "5860",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000499",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Brandt, PHARM.D.
• Andrew Spencer Brawner
• Breiter Tech Corp
• Naisha Bretous
• Garlan Brosnahan
• James David Burrill, MD
• Chante Butler
• Elisabeth Marie Butler, NURSE PRACTITIONER
• Glenda Byhouwer, LICSW, LCDP, CDCS
• Shachan Jose Cabral, BCBA

• Dermatology Physician in Lincoln, RI
• Providers in Lincoln, RI by specialty
• Dermatology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.