Lisa M Brusca, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

010935 Issued in NY

Practice address

975 Stewart Ave
Garden City, NY 11530-4816

Phone

(516) 222-8600

NPI assigned

Jan 19, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1528048246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 STEWART AVENUE",
            "address_2": "CARDIOVASCULAR MEDICAL ASSOCIATES",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "718-222-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304816",
            "telephone_number": "516-222-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSCA",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "010935",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Rose Broyles, LMSW
• Marcia Brucculeri
• Rebecca Brum
• Nicole Brunnhoelzl, MS, ATC/L
• Anthony M Bruno, MD
• BSD Anesthesia LLP
• Jarrett Buda, D.C.
• Prya M. Budhu, R.N
• Michelle Francine Bueti
• Stefanie Buissereth, AGNP-C

• Physician Assistant in Garden City, NY
• Providers in Garden City, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.