Individual provider Active NPI

Jessica Bruny

  • Speech-Language Pathologist
  • Worthington, MN
National Provider Identifier
1093271371
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
022218 Issued in NY
Practice address
1307 S Shore Dr
Worthington, MN 56187-1344
Phone
(507) 376-3175
NPI assigned
Feb 12, 2019
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 022218 NY Primary

Addresses

Primary practice location

1307 S Shore Dr
Worthington, MN 56187-1344

Mailing address

501 Midwood St Apt 2R
Brooklyn, NY 11225-4551
Phone (347) 251-4114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221221000884 NY Practitioner - Qualified Speech Language Pathologist 2961830641 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essential OT PT SLP and Psychology Services PLLCGroup PAC ID 9133486301, 5 clinicians

Practice addresses (Care Compare)

2703 Milburn Ave
Baldwin, NY 11510-4115
Phone (917) 499-8496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Essential OT, PT, SLP & Psychology Services, PLLC CurrentSince Oct 10, 2022 Accepting new patients
Global Speech Language Pathology PC Speech-Language Pathologist CurrentSince Jul 1, 2023 Accepting new patients
Essential Therapy Services of NJ Speech-Language Pathologist CurrentSince Oct 10, 2022 Accepting new patients
Speech & Swallow Matters LLC Speech-Language Pathologist Current Accepting new patients

Locations

1979 Marcus Ave
Ste 204
New Hyde Park, NY 11042
Phone (516) 327-4681

Organizations & group practices 5

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": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1093271371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MIDWOOD ST APT 2R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112254551",
            "telephone_number": "347-251-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 S SHORE DR",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871344",
            "telephone_number": "507-376-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNY",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.