Active NPI
Marc David Bruckner, DPM
- Podiatrist
- Livingston, NJ
National Provider Identifier
1902881527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 25MD00230000
- Practice address
- 13 Birch Tree LN
Pob 358
Livingston, NJ 07039-0358 - Phone
- (973) 535-6505
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 25MD00230000 | NJ | Primary |
Addresses
Primary practice location
13 Birch Tree LN
Pob 358
Livingston, NJ 07039-0358
Mailing address
PO Box 358
Livingston, NJ 07039-0358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101019001344 | NJ | Practitioner - Podiatry | 0547453862 | Practice locations: Livingston, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
13 Birch Tree LN
Livingston, NJ 07039-1202
Phone (973) 535-6505
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 30 |
| Removal of nail tissue | 2101 |
| Removal or shaving of skin growth | 888 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MD00230000 | NJ | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1902881527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 358",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070390358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 BIRCH TREE LN",
"address_2": "POB 358",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070390358",
"telephone_number": "973-535-6505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCKNER",
"first_name": "MARC",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NJ",
"license": "25MD00230000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livingston, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.