BRENNAN T REEDER (PA-C) – Physician Assistant, NPI 1063991958

BRENNAN T REEDER (PA-C) is a healthcare provider. based in Rockford, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 085007247 (IL). The NPI Number for BRENNAN T REEDER (PA-C) is 1063991958

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
BRENNAN T REEDER (PA-C)
NPI
1063991958
Phone
(815) 490-1600
Address
1200 WEST STATE STREET
Enumeration Date
10 August 2018
Last Update Date
17 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8155392663
Graduation Year
2019 (7 years ago)
PAC ID
9436582673
Group Practice PAC ID
2264335777
Professional Enrollment ID
I20231013000195
Address ID
IL613429010ME1405XSTXX405
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for BRENNAN T REEDER (PA-C)

  • West State Street, Rockford, Winnebago County, Illinois, 61102, United States

    ROCKFORD, IL 611022112

    Phone: (815) 490-1600

    Fax: (815) 815-1881

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-07-10 • Largest payer in this snapshot: Phadia US Inc. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Phadia US Inc.$14
View all Open Payments →|Open Payments Risk Radar →

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: 2023-10-13

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231013000195IPhysician AssistantILTBD

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.

Verify on CMS Revalidation Lookup Tool

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 61102)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264335777View full group profile
NameSpecialtyState
Nurse PractitionerIL
Internal MedicineIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Family PracticeIL
Family PracticeWI
Nurse PractitionerIL
Nurse PractitionerIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

Can I verify BRENNAN T REEDER (PA-C) with an NPI only?
You can start verification with NPI 1063991958 for BRENNAN T REEDER (PA-C), then check state licensing separately.
Is BRENNAN T REEDER (PA-C) still practicing?
BRENNAN T REEDER (PA-C) is currently listed as active in the public NPI registry.
What is BRENNAN T REEDER (PA-C)'s primary classification?
Physician Assistant is the headline specialty for BRENNAN T REEDER (PA-C) here. Clinical services aligned with this taxonomy classification.
What area does BRENNAN T REEDER (PA-C) serve?
BRENNAN T REEDER (PA-C)'s listing highlights Rockford, Illinois; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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