Robert L Bruckstein, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

117212-1 Issued in NY

Practice address

290 Central Ave
Suite 206
Lawrence, NY 11559-8507

Phone

(516) 239-2332

Fax

(516) 371-2251

NPI assigned

Jul 31, 2005

Last updated

Nov 10, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

New York University School of Medicine, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Barnegat Nursing & Rehab LLC

  dba Barnegat Rehabilitation and Nursing Center

  • Skilled Nursing Facility
  • Barnegat, NJ
  • NPI 1629403324

  5% Or Greater Direct Ownership Interest, Adp of the SNF

  CMS ownership
• Bloomingdale Nursing & Rehabilitation LLC

  dba The Health Center At Bloomingdale

  • Skilled Nursing Facility
  • Bloomingdale, NJ
  • NPI 1194149807

  Adp of the SNF, Direct Ownership Interest

  CMS ownership
• Galloway Nursing & Rehab LLC

  dba The Health Center at Galloway

  • Skilled Nursing Facility
  • Galloway, NJ
  • NPI 1144666579

  Adp of the SNF, Direct Ownership Interest

  CMS ownership
• Highland Manor Nursing & Rehabilitation, LLC

  dba Highland Manor Rehabilitation And Nursing Center

  • Skilled Nursing Facility
  • Exeter, PA
  • NPI 1104240811

  5% Or Greater Direct Ownership Interest, Adp of the SNF

  CMS ownership
• Majestic Oaks Nursing & Rehabilitation LLC

  dba Majestic Oaks Rehabilitation And Nursing Center

  • Skilled Nursing Facility
  • Warminster, PA
  • NPI 1669896379

  Adp of the SNF, Direct Ownership Interest

  CMS ownership

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.

• Robert L Bruckstein MD PC

  • Dermatology Physician
  • Lawrence, NY
  • NPI 1194002733
  Medicare reassignment Authorized official
• Comprehensive Dermatology, P.C.

  • Specialist
  • Woodmere, NY
  • NPI 1659417038
  NPD
• St John's Medical Services PC

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1023042173
  NPD (past)

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

{
    "created_epoch": "1122768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1386644375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE",
            "address_2": "SUITE 206",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "516-239-2332",
            "fax_number": "516-371-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE",
            "address_2": "SUITE 206",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "516-239-2332",
            "fax_number": "516-371-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKSTEIN",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-31",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "117212-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00216904",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Brazil
• Rubin Brecher, MD
• Debra L Breitman, DPM
• Rivkah Breuer
• Aviva Brody
• Bonnie Budman, LCSW
• Ca SNF Physicians PLLC
• Alicia May Camuso, MS SPECIAL EDUCATION
• Frank Capone, D.C.
• Cardiac Rhythm Consultants, PC

• Dermatology Physician in Lawrence, NY
• Providers in Lawrence, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.