Individual provider Active NPI

Shelby T Bruno, CRNP

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1093312209
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R222918 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1590
Phone
(410) 328-5720
Fax
(410) 328-5685
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R222918 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1590

Mailing address

PO Box 64442
Baltimore, MD 21264-4442
Phone (410) 328-8040

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210902001670 MD Practitioner - Nurse Practitioner 5395141121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Maryland School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-8040

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R222918MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians P.a. CurrentSince May 29, 2021 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
University of Maryland Physicians PA CurrentSince May 29, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

29 S Greene St
Fl 2
Baltimore, MD 21201
Phone (410) 328-5408

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1093312209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-328-8040",
            "fax_number": "443-462-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011590",
            "telephone_number": "410-328-5720",
            "fax_number": "410-328-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "SHELBY",
        "middle_name": "T",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R222918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.