Organization Active NPI

Hanna Brucker LLC

  • Chiropractor
  • West Roxbury, MA
National Provider Identifier
1780458810
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HANNA BRUCKER LLC
Practice address
1860 Centre St
West Roxbury, MA 02132-1902
Phone
(617) 588-4272
NPI assigned
Nov 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Hanna Brucker, DCNPI 1912553371
Title
Owner
Phone
(401) 744-0165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1860 Centre St
West Roxbury, MA 02132-1902

Mailing address

1860 Centre St
West Roxbury, MA 02132-1902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240503001116 MA Part B Supplier - Clinic/Group Practice 7719327006 Receives reassigned benefits from 1 practitioner
Practice locations: West Roxbury, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1780458810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 CENTRE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021321902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CENTRE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021321902",
            "telephone_number": "617-588-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNA BRUCKER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "BRUCKER",
        "authorized_official_first_name": "HANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-744-0165",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.