BROGAN REPP – Nurse Practitioner, NPI 1295431823

BROGAN REPP is a healthcare provider. based in Round lake, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 041413004 (IL). The NPI Number for BROGAN REPP is 1295431823

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
BROGAN REPP
NPI
1295431823
Phone
(847) 722-0063
Address
34159 N HAINESVILLE RD
Enumeration Date
6 February 2023
Last Update Date
5 January 2024

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
8152063400
Graduation Year
2022 (4 years ago)
PAC ID
6901251974
Group Practice PAC ID
5890696231
Professional Enrollment ID
I20231011000869
Address ID
IL600987509WO3701XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:3State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for BROGAN REPP

  • 34159 N HAINESVILLE RD

    ROUND LAKE, IL 600739790

    Phone: (847) 722-0063

    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)

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: 2023-10-11

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
I20231011000869INurse PractitionerILTBD

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 60073)

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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: 5890696231View full group profile
NameSpecialtyState
General SurgeryIL
Vascular SurgeryIL
-IL
Nurse PractitionerIL
-IL
C H I R O P R A C T I CIL
Family PracticeIL
Physical Medicine And RehabilitationCO
-IL
Hospitalist, Family PracticeIL

Reviews

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Frequently asked questions

What identifier follows BROGAN REPP across health systems?
The NPI 1295431823 uniquely identifies BROGAN REPP in U.S. healthcare data.
Does the public listing show BROGAN REPP as active?
BROGAN REPP's NPI record reflects an active status in NPPES.
What does the directory say BROGAN REPP does?
Insurance directories may phrase it differently, but here BROGAN REPP maps to Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is BROGAN REPP tied to Round Lake, Illinois?
If you are local to Round Lake, Illinois, BROGAN REPP may be relevant to your search.
Can I export BROGAN REPP's record?
You can download the official NPPES record; we summarize key fields for readability.

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