Individual provider Active NPI

Ximena Jordan Bruno, M.D.

  • Hematology (Internal Medicine) Physician
  • Philadelphia, PA
National Provider Identifier
1881089746
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
MD474997 Issued in PA
Practice address
3400 Spruce Street
Philadelphia, PA 19104-4204
Phone
(215) 615-0063
Fax
(215) 349-8144
NPI assigned
Mar 30, 2015
Last updated
Dec 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X MD474997 PA Primary

Addresses

Primary practice location

3400 Spruce Street
Philadelphia, PA 19104-4204

Mailing address

3400 Spruce Street
Philadelphia, PA 19104-4204
Phone (215) 615-0063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20210811001215 PA Practitioner - Internal Medicine 3274831110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Hematology CurrentSince Jul 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2021 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

3400 Civic Center Blvd
#4W
Philadelphia, PA 19104
Phone (215) 662-2300

3400 Civic Center Blvd
Fl 3
Philadelphia, PA 19104
Phone (215) 614-4100

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1881089746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044204",
            "telephone_number": "215-615-0063",
            "fax_number": "215-349-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044204",
            "telephone_number": "215-615-0063",
            "fax_number": "215-349-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN BRUNO",
        "first_name": "XIMENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "PA",
            "license": "MD474997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.