DR. RICHARD L BRUCKNER M.D.
NPI 1417124264
Pediatrics - Pediatric Emergency Medicine in Stony Brook, NY
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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).
Medicare Billing Reassignments
5Medicare enrollment records show Richard Bruckner reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Stony Brook, NY 11794
- Reassigned Medicare billing, New York enrollment
- 191 clinicians in this Medicare group
Bay Shore, NY 11706
- Reassigned Medicare billing, New York enrollment
- 395 clinicians in this Medicare group
West Islip, NY 11795
- Reassigned Medicare billing, New York enrollment
- 91 clinicians in this Medicare group
Great Neck, NY 11021
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
New York, NY 10021
- Reassigned Medicare billing, New York enrollment
- 226 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
STONY BROOK, NY 11794
STONY BROOK, NY 11794
STONY BROOK, NY 11794
STONY BROOK, NY 11794
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.
Which organizations bill Medicare for Richard Bruckner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Richard Bruckner reassigns Medicare benefits to 5 organizations: Stony Brook Children's Service, University Faculty Practice Corporatio (Stony Brook, NY), Good Samaritan Hospital Medical Center (Bay Shore, NY), Samaritan Emergency Medical Services, PC (West Islip, NY), North Shore-Lij Medical PC (Great Neck, NY) and Weill Medical College Of Cornell (New York, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Richard Bruckner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Dr. Richard L Bruckner, M.D. · NPI 1417124264
Pediatric Emergency Medicine physician in Stony Brook, New York. Individual provider, active in the CMS NPPES registry since May 12, 2008.
## Identity
- **NPI:** 1417124264 (Entity type: Individual)
- **Enumerated:** May 12, 2008
- **Primary specialty:** Pediatrics - Pediatric Emergency Medicine · taxonomy 2080P0204X
- **State license:** 240468 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 100 NICOLLS RD, LEVEL 4, Stony Brook, NY 11794-8111
- **Phone:** (631) 444-2499
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Stony Brook Children's Service, University Faculty Practice Corporatio (NPI 1083660575, Stony Brook, NY); Good Samaritan Hospital Medical Center (NPI 1275820961, Bay Shore, NY); Samaritan Emergency Medical Services, PC (NPI 1104978014, West Islip, NY); North Shore-Lij Medical PC (NPI 1053688572, Great Neck, NY); Weill Medical College Of Cornell (NPI 1245355270, New York, NY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 26, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1417124264) · Data from the CMS NPPES public registry.