Jason Bruno, N.P.
Individual provider Active NPI Family Nurse Practitioner · Michigan City, IN
NPI 1780145904 · NPPES record last updated Dec 20, 2022
Key facts
- NPI
- 1780145904
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71008913A (IN)
- Practice address
- 4111 Franklin St
Michigan City, IN 46360-7803 - Phone
- (219) 873-2919
- Fax
- (219) 873-2909
- NPI assigned
- Mar 29, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Franciscan Physician Network
Practice addresses (Care Compare)
4111 Franklin St
Michigan City, IN 46360-7803
Phone (219) 873-2919
Hospital & facility affiliations
- Franciscan Health Crown Point
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190507001921 | IN | Practitioner - Nurse Practitioner | 3173865441 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28235051A | IN | MD | Family Nurse Practitioner |
| 71008913A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Physician Network | Current |
Accepting new patients | |
| Franciscan Physician Network | Current |
Accepting new patients | |
| Franciscan Physician Network | Current | Accepting new patients |
Locations
1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120
12800 Mississippi Pkwy
Ste B100
Crown Point, IN 46307
Phone (219) 662-5700
4111 Franklin St
Michigan City, IN 46360
Phone (219) 873-2919
150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28235051A | IN | |
| Family Nurse Practitioner | 363LF0000X | 71008913A | IN | Yes |
Addresses
Primary practice location
4111 Franklin St
Michigan City, IN 46360-7803
Mailing address
PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800
Other practice location 1
12800 Mississippi Pkwy Ste B100
Crown Point, IN 46307-6901
Phone (219) 662-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 471400568 | Other | IN | MEDICARE |
| 300025272 | Medicaid | IN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbruno199564@Direct.FranciscanAlliance.org | Direct |
Other providers in Michigan City, IN
- Bright View Vision Care LLC
- Brighter Beginnings Counseling, LLC
- Jessica Sophia Bronner
- June Barco Brown
- Bruce E. Nagel D.D.S., Inc.
- Kristen Renee Bryan
- Quinton W Bryan
- Kevin Michael Bryant
- Kevin Burke
- Sarah Burke
All providers in Michigan City, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.