JARED EDWARD BRUDER (ARNP) – Geriatric Medicine (Family Medicine) Physician, NPI 1023654548
Geriatric Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,798 NURSE PRACTITIONER in ID
Provider Addresses for JARED EDWARD BRUDER (ARNP)
1110 W Park Pl Ste 320
Coeur D Alene, ID 838142783
Phone: (208) 261-2255
Fax: (208) 473-7271
Type: Location
5015 S REGAL ST APT B2014
SPOKANE, WA 992237906
Phone: (509) 237-2386
Type: Mailing
5901 N Lidgerwood St Ste 223
Spokane, WA 992081122
Phone: (509) 444-8200
Type: Location
611 N IRON BRIDGE WAY
SPOKANE, WA 992024932
Phone: (509) 444-8888
Type: Mailing
5901 N LIDGERWOOD ST STE 223
SPOKANE, WA 992081122
Phone: (509) 444-8200
Type: Location
1110 W PARK PL STE 303
COEUR D ALENE, ID 838142784
Phone: (208) 261-2255
Fax: (208) 473-7271
Type: Mailing
1110 W PARK PL STE 320
COEUR D ALENE, ID 838142783
Phone: (208) 261-2255
Type: Location
107 S DIVISION ST
SPOKANE, WA 992021510
Phone: (509) 838-4651
Fax: (509) 456-4536
Type: Mailing
505 E NORTH FOOTHILLS DR
SPOKANE, WA 992072101
Phone: (509) 838-4651
Fax: (509) 456-4536
Type: Location
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: 2021-05-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20210510000979 | I | Nurse Practitioner | ID | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83814)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | ID | |
| Marriage And Family Therapist | ID | |
| Mental Health Counselor | ID | |
| Clinical Social Worker | UT | |
| Marriage And Family Therapist | ID | |
| Mental Health Counselor | WA | |
| Marriage And Family Therapist | ID |
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