EDMUND BRUNING – Physician Assistant, NPI 1801679469

EDMUND BRUNING is a healthcare provider. based in Mascoutah, Illinois. specializing in PHYSICIAN ASSISTANT. They hold a License No. 2023043101 (MO). The NPI Number for EDMUND BRUNING is 1801679469

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
EDMUND BRUNING
NPI
1801679469
Phone
Not provided
Address
10630 TOWN HALL RD
Enumeration Date
17 August 2023
Last Update Date
28 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6182885711
Graduation Year
2023 (3 years ago)
PAC ID
7315394038
Group Practice PAC ID
3072908474
Professional Enrollment ID
I20240911000344
Address ID
IL620628500MA6800X162X400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for EDMUND BRUNING

  • 10630 TOWN HALL RD

    MASCOUTAH, IL 622583942

    Phone:

    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 $84.

Total Amount is formed as General ($84) + Research ($0) + Ownership ($0) = $84.

Last reported payment date: 2024-09-26 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($84).

Total Amount

$84

General + Research + Ownership

Payments

1

Total payment records

General Amount

$84

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-26

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2024-09-11

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231116002844IPhysician AssistantMOTBD
I20240911000344IPhysician 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 62258)

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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: 3072908474View full group profile
NameSpecialtyState
Internal Medicine, Pediatric MedicineMO
Physician AssistantIL
Family PracticeIL
Internal Medicine, HospitalistMO
Internal Medicine, Pediatric MedicineIL
Hospitalist, Emergency MedicineWI
Family PracticeMO
Hospitalist, Internal MedicineIL
Internal Medicine, Hospitalist, Internal MedicineMO
Nurse PractitionerLA

Reviews

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Frequently asked questions

How is EDMUND BRUNING identified in CMS data?
CMS-hosted NPPES data lists EDMUND BRUNING with NPI 1801679469.
Can I rely on EDMUND BRUNING being an active provider?
As of the registry snapshot, EDMUND BRUNING is marked active.
What is EDMUND BRUNING best known for clinically?
Directory data describes EDMUND BRUNING with Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for EDMUND BRUNING?
EDMUND BRUNING's geographic hint is Mascoutah, Illinois in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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