Gary Jr. Brucato, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019614 Issued in NY

Practice address

276 5TH Ave RM 605
New York, NY 10001-4527

Phone

(917) 847-7556

NPI assigned

Jan 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Gary Brucato Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 18, 2024 through Feb 18, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1326638719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7143 58TH AVE",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113782662",
            "telephone_number": "347-351-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 5TH AVE RM 605",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014527",
            "telephone_number": "917-847-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCATO",
        "first_name": "GARY",
        "middle_name": "JR.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "BRUCATO",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sara Grace Brubaker, MD
• Amina Brucaj
• Seada Brucaj
• Debbie Marie Brucato-Duncan, ACNP-BC
• Christopher Brucato
• Julia Brucato, SLP-CF / TSSLD
• Bruce Deitchman, M.D., LLC
• Bruce E. Katz, MD, PC
• Bruce E. Katz, MD, PC
• Bruce E. Katz, MD, PC

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.