JOHN PHILIP BRYAN (PA-C) – Surgical Physician Assistant, NPI 1083614127

JOHN PHILIP BRYAN (PA-C) is a healthcare provider. based in Evansville, Indiana. specializing in Surgical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. 5601002612 (MI). The NPI Number for JOHN PHILIP BRYAN (PA-C) is 1083614127

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
JOHN PHILIP BRYAN (PA-C)
NPI
1083614127
Phone
(812) 477-1558
Address
225 CROSSLAKE DR
Enumeration Date
29 July 2005
Last Update Date
24 August 2015

Doctor Profile

Medical School Name
WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Secondary Phone
9207435566
Graduation Year
1990 (36 years ago)
PAC ID
3274439435
Group Practice PAC ID
5395735088
Professional Enrollment ID
I20150818006154
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for JOHN PHILIP BRYAN (PA-C)

  • 225, Crosslake Drive, Evansville, Vanderburgh County, Indiana, 47715, United States

    EVANSVILLE, IN 477158198

    Phone: (812) 477-1558

    Fax: (812) 488-4669

    Type: Location

  • 323S 18TH AVE

    STURGEON BAY, WI 542351401

    Phone: (920) 743-5566

    Fax: (920) 746-3515

    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: 2024-12-04

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
I20231103002568IPhysician AssistantNDTBD
I20241204004684IPhysician AssistantNMTBD

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 47715)

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Provider's Procedures

JOHN PHILIP BRYAN (PA-C) performs procedures in Surgical Physician Assistant. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTIN27447Repair of knee joint3937

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: 5395735088View full group profile
NameSpecialtyState
Nurse PractitionerWI
-WI
Nurse PractitionerKS
Nurse PractitionerWI
Nurse PractitionerWI
Nurse PractitionerWI
-WI
Nurse PractitionerIL
Internal MedicineWI
Clinical Social WorkerWI

Reviews

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Frequently asked questions

Is JOHN PHILIP BRYAN (PA-C) listed with a National Provider Identifier?
Yes — JOHN PHILIP BRYAN (PA-C) has NPI 1083614127 on file in the registry.
Is JOHN PHILIP BRYAN (PA-C) still an active registrant?
JOHN PHILIP BRYAN (PA-C) carries an active NPI according to the public dataset.
How would a patient describe JOHN PHILIP BRYAN (PA-C)'s focus?
For JOHN PHILIP BRYAN (PA-C), the primary taxonomy reads as Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is JOHN PHILIP BRYAN (PA-C) associated with Evansville?
Public fields place JOHN PHILIP BRYAN (PA-C) around Evansville, Indiana. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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