Individual provider Active NPI

Martin D Bruner, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1790712289
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072671 Issued in NY
Practice address
259 Bristol St FL 3
Brooklyn, NY 11212-5540
Phone
(718) 345-5000
Fax
(718) 732-2548
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072671 NY Primary

Addresses

Primary practice location

259 Bristol St FL 3
Brooklyn, NY 11212-5540

Mailing address

592 Rockaway Ave
Brooklyn, NY 11212-5539
Phone (718) 345-5000

Other practice location 1

1167 Nostrand Ave
Brooklyn, NY 11225-5417
Phone (718) 778-0198

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070330000447 NY Practitioner - Clinical Social Worker 9234233206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brownsville Community Development CorporationGroup PAC ID 7416903323, 18 clinicians

Practice addresses (Care Compare)

259 Bristol St
FL 3
Brooklyn, NY 11212-5540
Phone (718) 342-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072671NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brownsville Community Development Corporation CurrentSince Aug 28, 2021 Accepting new patients
Brownsville Community Development Corporation CurrentSince Feb 2, 2020 Accepting new patients
Brownsville Community Development Corporation CurrentSince Feb 2, 2020 Accepting new patients

Locations

259 Bristol St
Fl 3
Brooklyn, NY 11212
Phone (718) 342-0060

592 Rockaway Ave
Brooklyn, NY 11212
Phone (718) 345-5000

650 Ashford St
Brooklyn, NY 11207
Phone (347) 505-1800

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: martin.bruner@chn.eclinicaldirectplus.com
  • Direct secure messaging: martin.bruner.1@13126.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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1790712289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 ROCKAWAY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112125539",
            "telephone_number": "718-345-5000",
            "fax_number": "718-345-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 BRISTOL ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112125540",
            "telephone_number": "718-345-5000",
            "fax_number": "718-732-2548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1167 Nostrand Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112255417",
            "country_code": "US",
            "telephone_number": "718-778-0198",
            "fax_number": "718-221-8169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "MARTIN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.