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DR. RICHARD L BRUCKNER M.D.
NPI 1417124264
Pediatrics - Pediatric Emergency Medicine in Stony Brook, NY

Active since May 12, 2008PECOS Enrolled
100 NICOLLS RD, LEVEL 4, STONY BROOK, NY 11794(631) 444-2499 Get Directions Write a Review

NPPES record last updated: April 26, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Richard L Bruckner M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RICHARD L BRUCKNER M.D. (NPI 1417124264) is an individual pediatric emergency medicine provider in Stony Brook, New York, licensed in New York (240468) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417124264
Entity TypeIndividualMale
Primary Taxonomy2080P0204X
Provider Legal NameDR. RICHARD L BRUCKNERCredential: M.D.
Location Address100 NICOLLS RD, LEVEL 4Stony Brook, NY 11794-8111
Mailing AddressPo Box 1559, Pediatric Emergency MedicineStony Brook, NY 11790-0989 · (631) 444-0650
Phone(631) 444-2499
Sole ProprietorYes
Enumeration DateMay 12, 2008
Last NPPES UpdateApril 26, 2015
✔ NPI 1417124264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in NY · 240468
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
100 NICOLLS RD, Stony Brook, NY 11794
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Richard L Bruckner M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MALWINA WLOCH M.D.
Anesthesiology
100 NICOLLS RD, SUNY AT STONY BROOK - DEPARTMENT OF ANESTHESIOLOGY
STONY BROOK, NY 11794
Suffolk County (631) 444-2968
CHABIDOU SAMPAIN FNP
Psychiatry & Neurology (Geriatric Psychiatry)
100 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 358-1423
MISS KAITLYN SBROLLINI
Student in an Organized Health Care Education/Training Program
100 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 331-6388
DR. RASAN KASHYAP CHERALA MD
Internal Medicine
100 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (425) 753-8665
EMILY GRACE DEEHAN
Specialist/Technologist (Athletic Trainer)
100 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 632-6000
DR. MUHAMMAD IBRAHIM CHOUDRY MD
Anesthesiology
100 NICOLLS RD, HEALTH SCIENCES CENTER L4-060 (Z8480)
STONY BROOK, NY 11794
Suffolk County (631) 444-2975
DR. KEITH THOMAS DIAZ M.D.
Internal Medicine
100 NICOLLS RD
STONY BROOK, NY 11794
Suffolk County (631) 444-2754
DR. JOSEPH CABALLERO M.D.
Anesthesiology
100 NICOLLS RD, DEPT OF ANESTHESIOLOGY HEALTH SCIENCES CENTER L4 #060
STONY BROOK, NY 11794
Suffolk County (631) 444-2975

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard Bruckner's NPI number?

The NPI number for Richard Bruckner is 1417124264. It was assigned to this individual provider in the NPPES registry on May 12, 2008.

Where is Richard Bruckner located?

Richard Bruckner practices at 100 Nicolls Rd Level 4, Stony Brook, NY 11794. The listed phone number is (631) 444-2499.

What is Richard Bruckner's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Richard Bruckner enrolled in Medicare?

Yes. Richard Bruckner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Richard Bruckner was last updated on April 26, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.