DR. KURT RUSSELL BRAVATA (M.D.) – General Practice Physician, NPI 1790096170

DR. KURT RUSSELL BRAVATA (M.D.) is a healthcare provider. based in Buffalo, Missouri. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 2013030074 (MO). The NPI Number for DR. KURT RUSSELL BRAVATA (M.D.) is 1790096170

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. KURT RUSSELL BRAVATA (M.D.)
NPI
1790096170
Phone
(417) 345-6100
Address
201 S ASH ST
Enumeration Date
30 June 2010
Last Update Date
29 December 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4177450103
Graduation Year
2010 (16 years ago)
PAC ID
0547497034
Group Practice PAC ID
6002068723
Professional Enrollment ID
I20131206001257
Address ID
MO656688204HE18614STXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

2,330 FAMILY PRACTICE in MO

Provider Addresses for DR. KURT RUSSELL BRAVATA (M.D.)

  • 201 S ASH ST

    BUFFALO, MO 656228674

    Phone: (417) 345-6100

    Fax: (417) 345-6866

    Type: Location

  • 1500 N OAKLAND AVE

    BOLIVAR, MO 656133011

    Phone: (417) 328-6501

    Fax: (417) 328-6338

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 146 Open Payments records for all available years, with a total value of $2,310.

Total Amount is formed as General ($2,310) + Research ($0) + Ownership ($0) = $2,310.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: ABBVIE INC. ($383).

Total Amount

$2,310

General + Research + Ownership

Payments

146

Total payment records

General Amount

$2,310

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

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: 2013-12-06

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
I20131206001257IFamily PracticeMOTBD

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 65622)

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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: 6002068723View full group profile
NameSpecialtyState
C H I R O P R A C T I CMO
Nurse PractitionerMO
-MO
Nurse PractitionerMO
O P T O M E T R YMO
Nurse PractitionerMO
Nurse PractitionerFL
Family Practice, Hospice/Palliative CareMO
Physician AssistantMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

Can I cross-check DR. KURT RUSSELL BRAVATA (M.D.) using NPI 1790096170?
NPI 1790096170 belongs to DR. KURT RUSSELL BRAVATA (M.D.); compare other details if you need extra assurance.
Would DR. KURT RUSSELL BRAVATA (M.D.) appear as active to a payer?
You can treat DR. KURT RUSSELL BRAVATA (M.D.) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DR. KURT RUSSELL BRAVATA (M.D.)'s focus?
For DR. KURT RUSSELL BRAVATA (M.D.), the primary taxonomy reads as General Practice Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. KURT RUSSELL BRAVATA (M.D.)?
Travel planning: use Buffalo, Missouri as the reference point for DR. KURT RUSSELL BRAVATA (M.D.), then confirm.
When was this NPI issued?
Enumeration for DR. KURT RUSSELL BRAVATA (M.D.) is noted as June 30, 2010 where the registry provides it.

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