Individual provider Active NPI

Victoria Martel Bruno, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1235963133
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F354189-01 Issued in NY
Practice address
258 Saint Nicholas Ave
New York, NY 10027-5351
Phone
(212) 222-0075
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F354189-01 NY Primary

Addresses

Primary practice location

258 Saint Nicholas Ave
New York, NY 10027-5351

Mailing address

76 W 85TH St Apt 5E
New York, NY 10024-4519
Phone (203) 451-5569

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260406002683 NY Practitioner - Nurse Practitioner 9931674165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Columbia University College of Physicians and Surgeons, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10740 Queens Blvd
Suite 204
Forest Hills, NY 11375-4201

76 W 85TH St
Apt 5E
New York, NY 10024-4519

76 W 85TH St Apt
5E
New York, NY 10024-4519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F354189-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Hills Dermatology Group PLLC CurrentSince Sep 8, 2024 Accepting new patients

Organizations & group practices 1

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": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1235963133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 W 85TH ST APT 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244519",
            "telephone_number": "203-451-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 SAINT NICHOLAS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275351",
            "telephone_number": "212-222-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "VICTORIA",
        "middle_name": "MARTEL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F354189-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.