ETHAN D BRUBAKER (PA-C) – Physician Assistant, NPI 1861957169
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for ETHAN D BRUBAKER (PA-C)
4340 Kings Way
Valdosta, GA 316026921
Phone: (229) 333-9736
Type: Location
117 Oakland Pkwy
Leesburg, GA 317637201
Phone: (229) 420-1839
Type: Location
512 N Shady Ln
Dothan, AL 363032991
Phone: (334) 699-5747
Type: Location
107 Calumet Center Rd
LaGrange, GA 302416705
Phone: (706) 884-3274
Type: Location
6262, Veterans Parkway, Ogletree Woods, Columbus, Muscogee County, Georgia, 31909, United States
COLUMBUS, GA 319093540
Phone: (706) 324-6661
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-07-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190725001463 | I | Physician Assistant | AL | TBD |
| I20190725003559 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 57 | 29 | $0 |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 46 | 46 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 45 | 44 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 43 | 43 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 28 | 28 | $0 |
Insurance plans in this area (ZIP 31602)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NC | |
| Physician Assistant | GA | |
| Nurse Practitioner | FL | |
| Emergency Medicine, Family Practice | GA | |
| - | GA | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Family Practice | NJ | |
| - | GA | |
| Physician Assistant | GA |
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