Individual provider Active NPI

Maria Brusalis R.N.,P.C., RN

  • Registered Nurse
  • Holtsville, NY
National Provider Identifier
1568935609
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
382642-1 Issued in NY
Practice address
6 Alloy CT
Holtsville, NY 11742-2417
Phone
(631) 428-3371
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 382642-1 NY Primary

Addresses

Primary practice location

6 Alloy CT
Holtsville, NY 11742-2417

Mailing address

6 Alloy CT
Holtsville, NY 11742-2417
Phone (631) 428-3371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
382642-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1568935609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ALLOY CT",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117422417",
            "telephone_number": "631-428-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ALLOY CT",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117422417",
            "telephone_number": "631-428-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSALIS R.N.,P.C.",
        "first_name": "MARIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "382642-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holtsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.