Individual provider Active NPI

John Bruno

  • Mental Health Counselor
  • Hampton Bays, NY
National Provider Identifier
1063810786
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P87195 Issued in NY
Practice address
31 E Montauk Hwy
Hampton Bays, NY 11946-1816
Phone
(631) 723-3362
Fax
(631) 723-3365
NPI assigned
Dec 11, 2014
Last updated
Dec 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P87195 NY Primary

Addresses

Primary practice location

31 E Montauk Hwy
Hampton Bays, NY 11946-1816

Mailing address

18 Bruce Dr
Manorville, NY 11949-2807
Phone (631) 723-3362

Other identifiers 1

IdentifierTypeStateIssuer
P87195OtherNYNYSED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20240215001011 NY Practitioner - Mental Health Counselor 1355785528 Practice locations: Manorville, NY

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Manorville, NY 11949
Phone (516) 509-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P87195NYMDMental Health Counselor
006876NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Rockville Centre Past Accepting new patients
Catholic Charities of the Diocese of Rockville Centre Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1063810786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BRUCE DR",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492807",
            "telephone_number": "631-723-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 E MONTAUK HWY",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119461816",
            "telephone_number": "631-723-3362",
            "fax_number": "631-723-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P87195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYSED",
            "identifier": "P87195",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton Bays, NY

Sources for this page

Verify at the official NPI Registry.