Diane M Bruessow, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA8022 Issued in MA

Practice address

10 Main St Ste 3
Florence, MA 01062-3158

Phone

(718) 894-0301

Fax

(718) 894-0301

NPI assigned

Feb 7, 2007

Last updated

Feb 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12931/brand/1/csg/1/fhir/r4

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.

• Healthy Transitions, LLC

  • Health Service Clinic/Center
  • Montclair, NJ
  • NPI 1114116472
  NPD Authorized official
• Excel Urgent Care of Astoria PLLC

  • Urgent Care Clinic/Center
  • Howard Beach, NY
  • NPI 1235434036
  Medicare reassignment
• Glendale Family Medicine,PC

  • Family Medicine Physician
  • Glendale, NY
  • NPI 1346444734
  Medicare reassignment
• Transhealth, Inc.

  • Internal Medicine Physician
  • Florence, MA
  • NPI 1053913525
  NPD
• Ultrasonics Diagnostics LLC

  dba CityChoice Medical & Diagnostics

  • Physiological Laboratory
  • Glendale, NY
  • NPI 1215391883
  NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1063552487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MAIN ST UNIT 60538",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010627026",
            "telephone_number": "718-894-0301",
            "fax_number": "718-894-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MAIN ST STE 3",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010623158",
            "telephone_number": "718-894-0301",
            "fax_number": "718-894-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUESSOW",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004819-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00141700",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA1010",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA8022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "004819",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6421",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA8820",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MP00141700",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA1010",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Brown, MD
• Emil Barrett Brown
• Jennifer Brown
• Marisa Anne Brown, MSW, LICSW
• Shakara Brown
• Vikram Budhraja, M.D.
• Frances A. Burns, CCC-SLP
• Peter William Butler, M.D.
• Cailin Qualliotine LLC
• Jaime Marie Caplis, LICSW

• Medical Physician Assistant in Florence, MA
• Providers in Florence, MA by specialty
• Medical Physician Assistant in Massachusetts

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

Verify at the official NPI Registry.