DR. PROUSKEH BRUCE EBRAHIMPOUR (M.D.) – Adult Reconstructive Orthopaedic Surgery Physician, NPI 1124280417
Adult Reconstructive Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. PROUSKEH BRUCE EBRAHIMPOUR (M.D.)
Wyoming Medical Center East Campus, 6550, East 2nd Street, Casper, Natrona County, Wyoming, 82609, United States
CASPER, WY 826094321
Phone: (307) 266-4000
Fax: (307) 266-4545
Mailing address matches the actual address.
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.
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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: 2020-06-16
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 |
|---|---|---|---|---|
| I20200616000442 | I | Orthopedic Surgery | NH | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 82609)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | WY | 73562 | X-ray of knee, 3 views | 31 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NH | |
| Nurse Practitioner | NH | |
| Nurse Practitioner | NH | |
| P O D I A T R Y | NH | |
| - | NH | |
| Physician Assistant | NH | |
| Family Practice, Hospitalist | NH | |
| Clinical Social Worker | CO | |
| Internal Medicine | MD | |
| Nurse Practitioner | NH |
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