Organization Active NPI

Peter J Bruno, MD PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1164452983
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
127274 Issued in NY
Legal business name
PETER J BRUNO, MD PC
Practice address
110 E 59TH St
Suite 9a
New York, NY 10022-1304
Phone
(212) 583-2898
Fax
(212) 644-2111
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter J Bruno, MDNPI 1912952185
Title
President
Phone
(212) 583-2898

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 127274 NY Primary

Addresses

Primary practice location

110 E 59TH St
Suite 9a
New York, NY 10022-1304

Mailing address

110 E 59TH St
Suite 9a
New York, NY 10022-1304
Phone (212) 583-2898

Other identifiers 1

IdentifierTypeStateIssuer
00370296MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110517000038 NY Part B Supplier - Clinic/Group Practice 3870779473 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

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
33D1032520Peter J Bruno MD PC110 East 59TH Street, Suite 9a, New York, NY 10022Certificate of waiverOct 25, 2026

National Provider Directory

National Provider Directory

Locations

110 E 59th St
Rm 9A
New York, NY 10022
Phone (212) 583-2850

Practitioners & affiliated clinicians

Practitioners 1

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164452983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 59TH ST",
            "address_2": "SUITE 9A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221304",
            "telephone_number": "212-583-2898",
            "fax_number": "212-644-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 59TH ST",
            "address_2": "SUITE 9A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221304",
            "telephone_number": "212-583-2898",
            "fax_number": "212-644-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER J BRUNO, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-583-2898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "127274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00370296",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.