Active NPI
Mark J Bruder, MSN, CRNP
- Nurse Practitioner
- York, PA
National Provider Identifier
1609864180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- UP005328B
- Practice address
- 1620 S. Queen St. Ste 2
York, PA 17403-4637 - Phone
- (800) 999-1249
- Fax
- (855) 656-7325
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R130259 | MD | |
| Nurse Practitioner | 363L00000X | UP005328B | PA | Primary |
Addresses
Primary practice location
1620 S. Queen St. Ste 2
York, PA 17403-4637
Mailing address
9800 Shelbyville Rd Ste 220
Louisville, KY 40223-2992
Phone (800) 999-1249
Other practice location 1
2800 Quarry Lake Drive
Suite 100
Baltimore, MD 21209-3770
Phone (410) 486-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500014862 | Other | MD | MEDICARE RR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1620 S Queen St
2 Family Allergy and Asthma
York, PA 17403-4637
Phone (800) 999-1249
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.25 of 100
- Quality
- 86.03
- Promoting interoperability
- 86
- Improvement activities
- 40
- Cost
- 73.15
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PSF PLLC | Nurse Practitioner | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
9800 Shelbyville Rd
Ste 220
Louisville, KY 40223
Phone (502) 429-8585
420 W Elm Ave
Ste 2
Hanover, PA 17331
420 W Elm Ave
Hanover, PA 17331
Phone (717) 632-4164
1620 S Queen St
York, PA 17403
Phone (717) 843-6663
1620 S Queen St
Ste 2
York, PA 17403
Phone (717) 843-6663
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gettysburg, PA
- NPI 1265466957
-
- General Acute Care Hospital
- Hanover, PA
- NPI 1730158981
-
- General Acute Care Hospital
- York, PA
- NPI 1326060492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1609864180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9800 SHELBYVILLE RD STE 220",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402232992",
"telephone_number": "800-999-1249",
"fax_number": "855-656-7325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 S. QUEEN ST. STE 2",
"city": "YORK",
"state": "PA",
"postal_code": "174034637",
"telephone_number": "800-999-1249",
"fax_number": "855-656-7325"
}
],
"practiceLocations": [
{
"address_1": "2800 Quarry Lake Drive",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212093770",
"country_code": "US",
"telephone_number": "410-486-2000",
"fax_number": "410-486-0825",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRUDER",
"first_name": "MARK",
"middle_name": "J",
"credential": "MSN, CRNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R130259",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "UP005328B",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "500014862",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.