Elena Bruck, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

226544 Issued in NY

Practice address

80 5TH Ave RM 1405
New York, NY 10011-8002

Phone

(917) 733-2867

Fax

(646) 453-7665

NPI assigned

Aug 17, 2007

Last updated

Oct 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Village Group Medical PC

  • Psychiatry Physician
  • New York, NY
  • NPI 1275348823
  NPD (past)

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1275725723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 5TH AVE RM 1405",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118002",
            "telephone_number": "917-733-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH AVE RM 1405",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118002",
            "telephone_number": "917-733-2867",
            "fax_number": "646-453-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCK",
        "first_name": "ELENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "226544",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "226544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Leigh Slusser Bruce
• Wendy Bruce, PHYSICIAN ASSISTANT
• Chantal Bruchez-Hall, PH.D.
• Laurie Jane Brucia, CNM
• Efrat Bruck
• Isaac Samuel Bruck, M.D., PH.D.
• Jason M Bruck, RN
• Benjamin M Brucker, MD
• Fredda Bruckner Gordon, DSW
• Ellie Bruckner

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.