BRANDON WYNN (DO) – Diagnostic Radiology Physician, NPI 1326250234
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,121 DIAGNOSTIC RADIOLOGY in IL
Provider Addresses for BRANDON WYNN (DO)
3050 MONTVALE DR STE A
SPRINGFIELD, IL 627046924
Phone: (217) 726-8096
Type: Location
3700 WASHINGTON AVE
EVANSVILLE, IN 477140541
Phone: (812) 485-4000
Type: Mailing
2040, West Iles Avenue, Springfield, Sangamon County, Illinois, 62704, United States
SPRINGFIELD, IL 627044183
Phone: (217) 789-0668
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: 2017-03-30
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 |
|---|---|---|---|---|
| I20100701000313 | I | Diagnostic Radiology | IL | TBD |
| I20170330002185 | I | Diagnostic Radiology | IN | 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 |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 795 | 588 | $0 |
| 71046 | X-ray of chest, 2 views | 568 | 532 | $0 |
| 77067 | Screening mammography | 346 | 176 | $0 |
| 77063 | Screening 3d breast mammography | 336 | 171 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 296 | 267 | $0 |
Insurance plans in this area (ZIP 62704)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | IL | 73110 | X-ray of wrist, minimum of 3 views | 19 | 19 |
| DIAGNOSTIC RADIOLOGY | IL | 73562 | X-ray of knee, 3 views | 25 | 21 |
| DIAGNOSTIC RADIOLOGY | IL | 73630 | X-ray of foot, minimum of 3 views | 20 | 18 |
| DIAGNOSTIC RADIOLOGY | IL | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 12 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| - | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | MI |
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