Organization Active NPI

Humberto R. Bruschetta, M.D., P.a.

  • Internal Medicine Physician
  • Kingsville, TX
National Provider Identifier
1437346228
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9634 Issued in TX
Legal business name
HUMBERTO R. BRUSCHETTA, M.D., P.A.
Practice address
2511 E Corral Ave
Kingsville, TX 78363-4101
Phone
(361) 516-0097
Fax
(361) 516-0182
NPI assigned
Sep 26, 2007
Last updated
Jan 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Dr. Humberto R Bruschetta, MD, FACP
Title
Owner
Phone
(361) 516-0097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 9634 TX Primary

Addresses

Primary practice location

2511 E Corral Ave
Kingsville, TX 78363-4101

Mailing address

2511 East Corral Ave
Kingsville, TX 78363-4101
Phone (361) 516-0097

Other identifiers 2

IdentifierTypeStateIssuer
079672401MedicaidTX
1760437438OtherTXNPI

National Provider Directory

National Provider Directory

Locations

500 E Caesar Ave
Kingsville, TX 78363
Phone (361) 516-0097

1301 E 8th St
Ste 103
Mission, TX 78572
Phone (956) 271-1030

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1437346228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 EAST CORRAL AVE",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783634101",
            "telephone_number": "361-516-0097",
            "fax_number": "361-516-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 E CORRAL AVE",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783634101",
            "telephone_number": "361-516-0097",
            "fax_number": "361-516-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBERTO R. BRUSCHETTA, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "BRUSCHETTA",
        "authorized_official_first_name": "HUMBERTO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-516-0097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FACP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "9634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079672401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760437438",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.