Individual provider Active NPI

Krista Bruno

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1366148298
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351260 Issued in NY
Practice address
2177 Victory Blvd
Staten Island, NY 10314-6603
Phone
(718) 370-3730
NPI assigned
Feb 2, 2023
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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 351260 NY Primary

Addresses

Primary practice location

2177 Victory Blvd
Staten Island, NY 10314-6603

Mailing address

2177 Victory Blvd
Staten Island, NY 10314-6603
Phone (718) 370-3730

Other practice location 1

4143 Richmond Ave
Staten Island, NY 10312-5637
Phone (718) 966-5556

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823000461 NY Practitioner - Nurse Practitioner 4183087224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
351260NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frank Scafuri III D.O.P,C CurrentSince Mar 1, 2023 Accepting new patients

Locations

2177 Victory Blvd
Staten Island, NY 10314
Phone (718) 370-3730

4143 Richmond Ave
Staten Island, NY 10312
Phone (718) 966-5556

682 Forest Ave
Staten Island, NY 10310
Phone (718) 370-3730

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.

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1366148298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146603",
            "telephone_number": "718-370-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146603",
            "telephone_number": "718-370-3730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4143 Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103125637",
            "country_code": "US",
            "telephone_number": "718-966-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "KRISTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.