Individual provider Active NPI

Rosemarie Bruno, LCSW

  • Clinical Social Worker
  • South Setauket, NY
National Provider Identifier
1336539519
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087162 Issued in NY
Practice address
3771 Nesconset Hwy Ste 102a
South Setauket, NY 11720
Phone
(631) 961-8836
Fax
(631) 961-8805
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 087162 NY Primary

Addresses

Primary practice location

3771 Nesconset Hwy Ste 102a
South Setauket, NY 11720

Mailing address

3771 Nesconset Hwy Ste 102a
South Setauket, NY 11720-1155
Phone (631) 961-8836

Other practice location 1

131 Route 25A Ste 4
Rocky Point, NY 11778-9098
Phone (631) 961-8836

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180807000185 NY Practitioner - Clinical Social Worker 1850649955 Practice locations: South Setauket, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3771 Nesconset Hwy
Suite 102a
South Setauket, NY 11720-1155
Phone (631) 961-8836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Parientes of Suffolk, LCSW PC Clinical Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1336539519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 NESCONSET HWY STE 102A",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201155",
            "telephone_number": "631-961-8836",
            "fax_number": "631-961-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 NESCONSET HWY STE 102A",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "11720",
            "telephone_number": "631-961-8836",
            "fax_number": "631-961-8805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Route 25A Ste 4",
            "address_purpose": "LOCATION",
            "city": "Rocky Point",
            "state": "NY",
            "postal_code": "117789098",
            "country_code": "US",
            "telephone_number": "631-961-8836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "ROSEMARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Setauket, NY

Sources for this page

Verify at the official NPI Registry.