Individual provider Active NPI

Brunilda Mara, CRNA

  • Certified Registered Nurse Anesthetist
  • Goldsboro, NC
National Provider Identifier
1265766158
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
006927 Issued in NC
Practice address
2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone
(919) 587-4720
NPI assigned
Sep 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F335946 NY
Registered Nurse 163W00000X 564054 NY
Certified Registered Nurse Anesthetist 367500000X 006927 NC Primary

Addresses

Primary practice location

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494

Mailing address

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170221002531 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719261668 Reassigns benefits to 3 organizations
I20230322002244 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719261668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rutgers New Jersey Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne Memorial Hospital IncGroup PAC ID 3971409079, 29 clinicians
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone (919) 731-6142

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
F335946NYMDNurse Practitioner
006927NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Registered Nurse CurrentSince Oct 31, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Jan 14, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Jan 14, 2017 Accepting new patients
Wayne Memorial Hospital Inc CurrentSince Feb 21, 2023 Accepting new patients
Wayne Memorial Hospital Inc CurrentSince Feb 21, 2023 Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Jul 6, 2021 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Oct 20, 2020 Accepting new patients
Wayne Health Physicians Current Accepting new patients

Locations

2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

111 E 210th St
Bronx, NY 10467

1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1265766158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349494",
            "telephone_number": "919-587-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARA",
        "first_name": "BRUNILDA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F335946",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "564054",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "006927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.