MOLLYANNE ELIZABETH GIBSON BRUNKOW (MD) – Family Medicine Physician, NPI 1487114971
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,706 FAMILY PRACTICE in TX
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Provider Addresses for MOLLYANNE ELIZABETH GIBSON BRUNKOW (MD)
John Peter Smith Hospital, 1500, South Main Street, Fort Worth, Tarrant County, Texas, 76104, United States
FORT WORTH, TX 761044917
Phone: (817) 702-1244
Type: Mailing
PO BOX 741331
ATLANTA, GA 303741331
Phone: (913) 469-0503
Fax: (913) 338-1311
Type: Mailing
15101 GLENWOOD AVE
STANLEY, KS 662233154
Phone: (913) 681-8866
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 86 Open Payments records for all available years, with a total value of $1,553.
Total Amount is formed as General ($1,553) + Research ($0) + Ownership ($0) = $1,553.
Last reported payment date: 2024-11-25 • Largest payer in this snapshot: ABBVIE INC. ($346).
Total Amount
$1,553
General + Research + Ownership
Payments
86
Total payment records
General Amount
$1,553
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $346 |
| Lilly USA, LLC | $273 |
| Teva Pharmaceuticals USA, Inc. | $132 |
| IDORSIA PHARMACEUTICALS US INC | $130 |
| Novo Nordisk Inc | $76 |
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: 2022-09-23
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220923000921 | I | Family Practice | KS | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 157 | 117 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 53 | 47 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 28 | 28 | $0 |
| 71046 | X-ray of chest, 2 views | 13 | 13 | $0 |
Insurance plans in this area (ZIP 76104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KS | |
| - | CO | |
| Family Practice, Anesthesiology | GA | |
| General Surgery | MO | |
| Physician Assistant | KS | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KS | |
| Family Practice | GA |
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