Individual provider Active NPI

Suellen Ranee Bruguera, APRN-FNP -BC

  • Family Nurse Practitioner
  • Grand Island, NE
National Provider Identifier
1245724137
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
112480 Issued in NE
Practice address
2620 W Faidley Ave
Grand Island, NE 68803-4205
Phone
(308) 384-4600
NPI assigned
Jun 14, 2018
Last updated
Jun 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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 112480 NE Primary

Addresses

Primary practice location

2620 W Faidley Ave
Grand Island, NE 68803-4205

Mailing address

1805 S Blaine St
Grand Island, NE 68803-6154
Phone (402) 984-0853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20180711000129 NE Practitioner - Nurse Practitioner 9335495092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians
Memorial Community Health IncGroup PAC ID 1355394040, shared by 5 NPIs, 16 clinicians

Practice addresses (Care Compare)

2620 W Faidley Ave
St Francis Medical Center
Grand Island, NE 68803-4205
Phone (308) 384-4600

609 O St
Aurora, NE 68818-1104
Phone (402) 694-3191

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112480NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1245724137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 S BLAINE ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688036154",
            "telephone_number": "402-984-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034205",
            "telephone_number": "308-384-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUGUERA",
        "first_name": "SUELLEN",
        "middle_name": "RANEE",
        "credential": "APRN-FNP -BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.