BRACKON W LUNDY (PT, DPT) – Physical Therapist, NPI 1689054678

BRACKON W LUNDY (PT, DPT) is a healthcare provider. based in Kansas city, Missouri. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 2015020034 (MO). The NPI Number for BRACKON W LUNDY (PT, DPT) is 1689054678

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
BRACKON W LUNDY (PT, DPT)
NPI
1689054678
Phone
(816) 941-2550
Address
13157 STATE LINE RD
Enumeration Date
4 June 2015
Last Update Date
9 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9132242990
Graduation Year
2015 (11 years ago)
PAC ID
0446564751
Group Practice PAC ID
4587085576
Professional Enrollment ID
I20160229000062
Address ID
KS662072534PR5200XTERX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,533 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MO

Provider Addresses for BRACKON W LUNDY (PT, DPT)

  • 13157 STATE LINE RD

    KANSAS CITY, MO 641451650

    Phone: (816) 941-2550

    Fax: (816) 941-2520

    Type: Mailing

  • 5200 W 94TH TER STE 112

    PRAIRIE VILLAGE, KS 662072534

    Phone: (913) 224-2990

    Fax: (913) 224-2992

    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: 2016-02-29

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
I20160229000062IPhysical Therapist In Private PracticeKSTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities30925$0
View full utilization report →

Insurance plans in this area (ZIP 64145)

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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: 4587085576View full group profile
NameSpecialtyState
-KS
Physical Therapist In Private PracticeKS
Physical Therapist In Private PracticeKS
Physical Therapist In Private PracticeKS
Physical Therapist In Private PracticeKS
Physical Therapist In Private PracticeKS
Physical Therapist In Private PracticeKS

Reviews

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Frequently asked questions

How is BRACKON W LUNDY (PT, DPT) identified in CMS data?
CMS-hosted NPPES data lists BRACKON W LUNDY (PT, DPT) with NPI 1689054678.
Is BRACKON W LUNDY (PT, DPT) listed as active for patients and plans?
The listing shows BRACKON W LUNDY (PT, DPT) as active in the NPI system.
What is BRACKON W LUNDY (PT, DPT)'s primary classification?
Physical Therapist is the headline specialty for BRACKON W LUNDY (PT, DPT) here. Clinical services aligned with this taxonomy classification.
What address line appears for BRACKON W LUNDY (PT, DPT)?
BRACKON W LUNDY (PT, DPT)'s geographic hint is Kansas City, Missouri in our summary view.
Why does BRACKON W LUNDY (PT, DPT) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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