Individual provider Active NPI

Nicole Renee Bruin, PA

  • Physician Assistant
  • Nashua, NH
National Provider Identifier
1528797206
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1995 Issued in NH
Practice address
280 Main St
Nashua, NH 03060-2919
Phone
(603) 577-3300
Fax
(603) 577-3398
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1995 NH Primary

Addresses

Primary practice location

280 Main St
Nashua, NH 03060-2919

Mailing address

PO Box 3677
Nashua, NH 03061-3677
Phone (603) 577-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20230403001960 NH Practitioner - Physician Assistant 9931574043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foundation Medical Partners IncGroup PAC ID 9436140456, 313 clinicians

Practice addresses (Care Compare)

10 Jones Rd
Milford, NH 03055-3100
Phone (603) 672-7600

280 Main St
Suite 320
Nashua, NH 03060-2920
Phone (603) 577-5375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Medical Partners Inc. CurrentSince May 1, 2023 Accepting new patients
Foundation Medical Partners Inc CurrentSince May 1, 2023 Accepting new patients
Southern New Hampshire Medical Center Past Accepting new patients

Locations

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

280 Main St
Nashua, NH 03060
Phone (603) 577-3080

22 Cotton Rd
Nashua, NH 03063
Phone (603) 899-6147

280 Main St
Ste 210
Nashua, NH 03060
Phone (603) 577-2759

Interoperability endpoints

  • FHIR API: https://epicproxyprd.solutionhealth.org/FHIR_PRD/MYCHART/api/FHIR/R4
  • Direct secure messaging: nbruin138140@direct.solutionhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1528797206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3677",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030613677",
            "telephone_number": "603-577-7900",
            "fax_number": "603-577-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MAIN ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030602919",
            "telephone_number": "603-577-3300",
            "fax_number": "603-577-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUIN",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.