Bruno Manduca, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

201385 Issued in NY

Practice address

184 Holden Blvd
Staten Island, NY 10314-5159

Phone

(718) 815-0710

Fax

(718) 761-0711

NPI assigned

Jul 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
• Prime Home Health Services, LLC Home health agency, Brooklyn, NY, CCN 337190
• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160
• Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Home Health Services, LLC

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1588843650
  Care Compare affiliation
• Prime Home Health Services, LLC

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1841491412
  Care Compare affiliation
• Richmond Medical Center

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1740389154
  Care Compare affiliation
• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation
• Visiting Nurse Service of New York Home Care II

  • Home Health Agency
  • New York, NY
  • NPI 1528059805
  Care Compare affiliation

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1790718013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 HOLDEN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145159",
            "telephone_number": "718-815-0710",
            "fax_number": "718-761-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 HOLDEN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145159",
            "telephone_number": "718-815-0710",
            "fax_number": "718-761-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDUCA",
        "first_name": "BRUNO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "201385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01613872",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Lisa Mandelbaum, LCSW
• Barry Mandell, D.D.S.
• Gurpreet Kaur Mander, OTR/L
• Anthony Stephen Mandracchia, DC
• Christina Mandry
• Alexandra Frances Manetta
• Eric Manevich, LICENSED OPTICIAN
• Gabrielle Nicole Manfredi, OTR/L
• Ronald A. Manfredi, M.D.
• Sofia Manfredi

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.