ILYA BUNIMOVICH (PA) – Physician Assistant, NPI 1730852377

ILYA BUNIMOVICH (PA) is a healthcare provider. based in St. louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 2021013043 (MO). The NPI Number for ILYA BUNIMOVICH (PA) is 1730852377

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
ILYA BUNIMOVICH (PA)
NPI
1730852377
Phone
(314) 257-8222
Address
WEST PAVILION, ROOM G120
Enumeration Date
29 July 2021
Last Update Date
28 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2020 (6 years ago)
PAC ID
9537566302
Group Practice PAC ID
0143608372
Professional Enrollment ID
I20210921001790
Address ID
MO631041016SA1225XBLVD400

Contacts

Secure Messaging
ibunimovich403144@direct-ehr-ssmhc.com
FHIR Endpoint
https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

1,854 PHYSICIAN ASSISTANT in MO

Provider Addresses for ILYA BUNIMOVICH (PA)

  • WEST PAVILION, ROOM G120

    3655 VISTA AVENUE

    ST. LOUIS, MO 631102602

    Phone: (314) 257-8222

    Type: Mailing

  • 1201 S GRAND BLVD

    SAINT LOUIS, MO 631041016

    Phone: (314) 257-8000

    Type: Location

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: 2021-09-21

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
I20210921001790IPhysician AssistantMOTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6032$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes2611$0
99239Hospital discharge day management, more than 30 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 63110)

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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: 0143608372View full group profile
NameSpecialtyState
Anesthesiology AssistantMO
Pediatric Medicine, Hematology/OncologyTN
Nurse PractitionerIL
Certified Registered Nurse Anesthetist (Crna)MO
Pediatric MedicineIL
G A S T R O E N T E R O L O G YWV
Pediatric Medicine, Cardiovascular Disease (Cardiology)MO
Infectious DiseaseOH
Physician AssistantMO
Pediatric Medicine, Cardiovascular Disease (Cardiology)MO

Reviews

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Frequently asked questions

What is the registry number for ILYA BUNIMOVICH (PA)?
The registry entry for ILYA BUNIMOVICH (PA) shows NPI 1730852377.
Should I treat ILYA BUNIMOVICH (PA) as an active provider?
Patients and plans typically see ILYA BUNIMOVICH (PA) as active in the national extract.
What type of care does ILYA BUNIMOVICH (PA) provide?
ILYA BUNIMOVICH (PA)'s profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
Which community is linked to ILYA BUNIMOVICH (PA)?
ILYA BUNIMOVICH (PA) shows a connection to St. Louis, Missouri in registry-derived data.
Who maintains ILYA BUNIMOVICH (PA)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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