Individual provider Active NPI

Jessica Danielle Bruns, NP-C

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1790027357
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2013009204 Issued in MO
Practice address
701 Seneca St Ste 646C
Buffalo, NY 14210-1351
Phone
(716) 995-4450
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95004121 CA
Family Nurse Practitioner 363LF0000X SP016093 PA
Family Nurse Practitioner 363LF0000X 53-76627 KS
Family Nurse Practitioner 363LF0000X 2013009204 MO Primary

Addresses

Primary practice location

701 Seneca St Ste 646C
Buffalo, NY 14210-1351

Mailing address

7755 Center Ave Ste 630
Huntington Beach, CA 92647-9152
Phone (657) 237-2450

Other practice location 1

5701 W 119th St Ste 220
Overland Park, KS 66209-3721
Phone (913) 498-8787

Other practice location 2

7755 Center Ave Ste 630
Huntington Beach, CA 92647-9152
Phone (657) 237-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130003614 CA Order and Referring Only - Nurse Practitioner 9537301122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95004121CAMDNurse Practitioner
53-76627KSMDFamily Nurse Practitioner
2013009204MOMDFamily Nurse Practitioner
SP016093PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Research Neurology Associates LLC PastSince Oct 17, 2018 Accepting new patients
Summit Medical Group, PLLC PastSince Jan 21, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessica.bruns.1@33202.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1790027357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7755 CENTER AVE STE 630",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926479152",
            "telephone_number": "657-237-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SENECA ST STE 646C",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142101351",
            "telephone_number": "716-995-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 W 119th St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662093721",
            "country_code": "US",
            "telephone_number": "913-498-8787",
            "fax_number": "913-498-1744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7755 Center Ave Ste 630",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926479152",
            "country_code": "US",
            "telephone_number": "657-237-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95004121",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016093",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76627",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013009204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.