NPIMap

Individual provider Active NPI

Nicole R Bruno, RPAC

  • Physician Assistant
  • New York, NY
National Provider Identifier
1851565964
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0122111 Issued in NY
Practice address
520 E 70TH St
Starr 341
New York, NY 10021-9800
Phone
(212) 746-7576
Fax
(212) 746-8383
NPI assigned
Apr 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00260700 NJ
Physician Assistant 363A00000X 0122111 NY Primary

Addresses

Primary practice location

520 E 70TH St
Starr 341
New York, NY 10021-9800

Mailing address

575 Lexington Ave
New York, NY 10022-6102
Phone (212) 746-7576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080808000714 NY Practitioner - Physician Assistant 6800960881 Reassigns benefits to 1 organization
I20121226000381 NJ Practitioner - Physician Assistant 6800960881 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone (609) 597-6011

30 Prospect Ave
Hackensack, NJ 07601-1915

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012211NYMDSpeech-Language Pathologist
0122111NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Jan 2, 2016 Accepting new patients
Weill Medical College of Cornell CurrentSince Jan 2, 2016 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Weill Medical College of Cornell Past Accepting new patients
Meridian Obstetrics and Gynecology Associates P C Past Accepting new patients

Locations

1610 Route 88
Ste 203
Brick, NJ 08724
Phone (732) 268-8470

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1100 Route 72 W
Ste 201
Manahawkin, NJ 08050
Phone (609) 597-0547

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

520 E 70th St
#341
New York, NY 10021
Phone (212) 746-7576

520 E 70th St
Ste 341
New York, NY 10021
Phone (212) 746-2087

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

520 E 70th St
New York, NY 10021
Phone (212) 746-0838

525 E 68th St
#M
New York, NY 10065
Phone (212) 746-2850

Interoperability endpoints

  • Direct secure messaging: nicole.bruno@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1851565964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226102",
            "telephone_number": "212-746-7576",
            "fax_number": "212-746-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 70TH ST",
            "address_2": "STARR 341",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100219800",
            "telephone_number": "212-746-7576",
            "fax_number": "212-746-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "NICOLE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00260700",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0122111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.