Organization Active NPI

Bruno Brown Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Chevy Chase, MD
National Provider Identifier
1104834597
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
BRUNO BROWN PLASTIC SURGERY, LLC
Practice address
5454 Wisconsin Ave
Suite 1210
Chevy Chase, MD 20815-6901
Phone
(301) 215-5955
Fax
(301) 215-5944
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Authorized official

Name
James BrunoNPI 1861439887
Title
MD
Phone
(301) 215-5955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

5454 Wisconsin Ave
Suite 1210
Chevy Chase, MD 20815-6901

Mailing address

5454 Wisconsin Ave
Suite 1210
Chevy Chase, MD 20815-6901
Phone (301) 215-5955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040310001377 DC Part B Supplier - Clinic/Group Practice 3375432297 Receives reassigned benefits from 3 practitioners
Practice locations: Chevy Chase, MD
O20070215000177 MD Part B Supplier - Clinic/Group Practice 3375432297 Receives reassigned benefits from 3 practitioners
Practice locations: Chevy Chase, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2169652Bruno/Brown Plastic Surgery5454 Wisconsin Avenue #1210, Chevy Chase, MD 20815Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1104834597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE 1210",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-215-5955",
            "fax_number": "301-215-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE 1210",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-215-5955",
            "fax_number": "301-215-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNO BROWN PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "301-215-5955"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.