SCOTT BRUDERER (PA) – Physician Assistant, NPI 1003988205
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for SCOTT BRUDERER (PA)
10433 S REDWOOD RD STE 2
SOUTH JORDAN, UT 840958502
Phone: (801) 260-1919
Fax: (801) 260-1441
Type: Mailing
96 E KIMBALLS LN STE 207
DRAPER, UT 840205025
Phone: (801) 576-2300
Type: Location
96 E Kimballs Ln Ste 207
Draper, UT 840205025
Phone: (801) 576-2300
Type: Location
1126 E 12300 S
DRAPER, UT 840209095
Phone: (801) 545-0500
Fax: (801) 545-0626
Type: Location
Rice Box, Atlanta BeltLine Eastside Trail, Atlanta, Georgia, 30308, United States
ATLANTA, GA 303841221
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $83.
Total Amount is formed as General ($83) + Research ($0) + Ownership ($0) = $83.
Last reported payment date: 2024-07-17 • Largest payer in this snapshot: Globus Medical, Inc. ($39).
Total Amount
$83
General + Research + Ownership
Payments
5
Total payment records
General Amount
$83
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Globus Medical, Inc. | $39 |
| DePuy Synthes Sales Inc. | $15 |
| Boston Scientific Corporation | $15 |
| Bioventus LLC | $13 |
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: 2005-10-17
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 |
|---|---|---|---|---|
| I20051017000899 | I | Physician Assistant | UT | 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 |
|---|---|---|---|---|
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 47 | 24 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 42 | 29 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 22 | 22 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 13 | 12 | $0 |
| 29826 | Shaving of part of shoulder bone and repair of ligament using an endoscope | 11 | 11 | $0 |
Insurance plans in this area (ZIP 84095)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | UT | 27447 | Repair of knee joint | 20 | 19 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| Nurse Practitioner | UT | |
| - | UT | |
| Emergency Medicine | GA | |
| Physician Assistant | UT | |
| Nurse Practitioner | UT | |
| - | UT | |
| - | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT |
Reviews
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