Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Adam R Bruccoleri, PA

Individual provider Physician Assistant · NPI 1629381124

Adam R Bruccoleri, PA is a Physician Assistant in Staten Island, New York. Qualified in 2010, 16 years ago. Practices with True North Medical Group PC, a 186-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
16
Licensed in
NY
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

475 Seaview Ave
Staten Island, NY 10305-3436
Phone: (718) 226-9158
Fax: (718) 226-6964
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 014091 (NY)

Record details

NPI number1629381124
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJuly 26, 2010
Last updated in NPPESDecember 1, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice True North Medical Group Pc — 186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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