Active NPI
Jessica Danielle Bruns, NP-C
- Family Nurse Practitioner
- Buffalo, NY
National Provider Identifier
1790027357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2013009204
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231130003614 | CA | Order and Referring Only - Nurse Practitioner | 9537301122 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95004121 | CA | MD | Nurse Practitioner |
| 53-76627 | KS | MD | Family Nurse Practitioner |
| 2013009204 | MO | MD | Family Nurse Practitioner |
| SP016093 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Research Neurology Associates LLC | Past | Accepting new patients | |
| Summit Medical Group, PLLC | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
-
- Neurology Physician
- Kansas City, MO
- NPI 1811012958
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1699722470
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.