NPIMap

Individual provider Active NPI

Sandra Denise Mary Bruno, M.D.

  • Internal Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1972533602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
020956 Issued in LA
Practice address
217 Sam Houston Jones Pkwy
Lake Charles, LA 70611-5603
Phone
(337) 217-1000
Fax
(337) 217-1004
NPI assigned
Jul 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 020956 LA Primary

Addresses

Primary practice location

217 Sam Houston Jones Pkwy
Lake Charles, LA 70611-5603

Mailing address

PO Box 13402
Lake Charles, LA 70612-3402
Phone (337) 217-1000

Other identifiers 1

IdentifierTypeStateIssuer
1677027MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101124000586 LA Practitioner - Internal Medicine 1052507431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

217 Sam Houston Jones Pkwy
Suite 101
Lake Charles, LA 70611-5644
Phone (337) 217-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra D.M. Bruno, M.D., LLC Internal Medicine CurrentSince Sep 8, 2010 Accepting new patients
Center for Orthopaedics PastSince Sep 8, 2010 Accepting new patients

Locations

217 Sam Houston Jones Pkwy
Ste 101
Lake Charles, LA 70611
Phone (337) 217-1000

Organizations & group practices 2

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972533602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13402",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706123402",
            "telephone_number": "337-217-1000",
            "fax_number": "337-217-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 SAM HOUSTON JONES PKWY",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115603",
            "telephone_number": "337-217-1000",
            "fax_number": "337-217-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "SANDRA",
        "middle_name": "DENISE MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "020956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1677027",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.