Individual provider Active NPI

Brucha Wanounou, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1962230607
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F35469801 Issued in NY
Practice address
17 W 9TH St
Brooklyn, NY 11231-2501
Phone
(718) 599-9090
NPI assigned
Jul 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F35469801 NY Primary

Addresses

Primary practice location

17 W 9TH St
Brooklyn, NY 11231-2501

Mailing address

5317 McKinley St
Hollywood, FL 33021-4636
Phone (929) 271-2677

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240814001733 NY Practitioner - Nurse Practitioner 8426596024 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Beacon Health Medical PCGroup PAC ID 1658804760, 36 clinicians

Practice addresses (Care Compare)

17 W 9TH St
Brooklyn, NY 11231-2501
Phone (718) 599-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F35469801NYMDFamily Nurse Practitioner

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
Ilyagu Medical PC CurrentSince Nov 28, 2024 Accepting new patients
Parkway Preventive Medical Care PLLC CurrentSince Jul 8, 2024 Accepting new patients
Beacon Health Medical PC CurrentSince Dec 1, 2024 Accepting new patients
Parcare Community Health Network Inc Past Accepting new patients

Locations

809 Southern Blvd
Bronx, NY 10459
Phone (347) 326-8999

202 Caton Ave
Brooklyn, NY 11218

17 W 9th St
Brooklyn, NY 11231
Phone (718) 599-9090

4303 14th Ave
Brooklyn, NY 11219
Phone (718) 436-7800

Networks

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1962230607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 MCKINLEY ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330214636",
            "telephone_number": "929-271-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112312501",
            "telephone_number": "718-599-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANOUNOU",
        "first_name": "BRUCHA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F35469801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.