Active NPI
Bruce M Brenner, MD
- Surgical Oncology Physician
- Boca Raton, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- License
- ME133095
- Practice address
- 701 NW 13TH St
Boca Raton, FL 33486-2305 - Phone
- (619) 955-5966
- NPI assigned
- May 12, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | ME133095 | FL | Primary |
Addresses
Primary practice location
701 NW 13TH St
Boca Raton, FL 33486-2305
Mailing address
701 NW 13TH St
Boca Raton, FL 33486-2305
Phone (615) 955-5966
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005000261W | Other | HUMANA | |
| 34210200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- George Washington University School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
242 Mason Ave
Staten Island, NY 10305-3408
Phone (718) 226-6832
256 Mason Ave
Staten Island, NY 10305-3408
256 Mason Ave B
Staten Island, NY 10305-3408
Phone (718) 226-1595
256 Mason Aveunue
Staten Island, NY 10305-3408
Phone (718) 226-1458
300 Community Dr
Manhasset, NY 11030-3816
300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229
330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550
350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 1-10 |
| Melanoma (skin cancer) excision | 19 |
| Removal of tissue | 14 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Staten Island University Hospital | Past | Accepting new patients | |
| University of Connecticut Health Center | Past | Accepting new patients |
Locations
300 Community Dr
Plandome, NY 11030
256 Mason Ave
Bldg C
Staten Island, NY 10305
Phone (718) 226-1300
256 Mason Ave
#C
Staten Island, NY 10305
Phone (718) 226-1251
475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- bbrenner24089@northwell.direct-ci.com
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.
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1407877137
-
- Clinical Medical Laboratory
- Farmington, CT
- NPI 1427031293
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Manhasset, NY
- NPI 1417965278
-
- Home Health Agency
- Westbury, NY
- NPI 1861464471
-
- General Acute Care Hospital
- Staten Island, NY
- NPI 1407877137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624838400000",
"number": "1699726125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 NW 13TH ST",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334862305",
"telephone_number": "615-955-5966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 NW 13TH ST",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334862305",
"telephone_number": "619-955-5966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "BRUCE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2021-06-28",
"certification_date": "2021-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "FL",
"license": "ME133095",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "005000261W",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34210200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.