Athena Marie Bruzzano, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

024502 Issued in NY

Practice address

928 Broadway Ste 301
New York, NY 10010-8156

Phone

(464) 216-0646

NPI assigned

Aug 15, 2019

Last updated

Aug 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Athena Marie McDonald-Smith Professional name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kathleen Vine MD PCGroup PAC ID 8921220310, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

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

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.

• Kathleen Vine MD PC

  • Dermatology Physician
  • New York, NY
  • NPI 1942612866
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1942856885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BEACH 123RD ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116941828",
            "telephone_number": "917-613-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108156",
            "telephone_number": "464-216-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUZZANO",
        "first_name": "ATHENA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATHENA",
            "last_name": "MCDONALD-SMITH",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John C Brust, MD
• Michael Adam Brustein, PSY.D
• Lois Eileen Brustman, M.D.
• Vita Bruter, RPA-C
• Jamila Nailah Brutus, NP
• James Enrico Bruzzese
• Amelia Bruzzi
• Victor Luciano Bruzzi, D.D.S.
• Kristina Bruzzo
• Bryan G. Forley, M.D., P.C.

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.