Individual provider Active NPI

Mark I. Brunner, M.D.

  • Gastroenterology Physician
  • Danville, KY
National Provider Identifier
1053386060
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
40350 Issued in KY
Practice address
212 S 2ND St
Danville, KY 40422-1804
Phone
(859) 236-5302
Fax
(859) 236-5025
NPI assigned
Feb 22, 2006
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 40350 KY Primary

Addresses

Primary practice location

212 S 2ND St
Danville, KY 40422-1804

Mailing address

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517-3094
Phone (859) 971-4695

Other identifiers 1

IdentifierTypeStateIssuer
7100006290MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbrunner30597@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070424000245 KY Practitioner - GastroenterologyPractitioner - Internal Medicine 7214913789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Cincinnati College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1740 Nicholasville Rd
Lexington, KY 40503-1499
Phone (859) 260-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy58
Upper gastrointestinal (GI) endoscopy for acid reflux177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jun 12, 2017 Accepting new patients
Wilderness Trace Anesthesia, PLLC Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jun 12, 2017 Accepting new patients

Locations

212 S 2nd St
Danville, KY 40422
Phone (606) 236-5302

1740 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-6100

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Interoperability endpoints

  • Direct secure messaging: mbrunner30597@bhkydirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1053386060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 TATES CREEK CENTRE DR",
            "address_2": "STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173094",
            "telephone_number": "859-971-4695",
            "fax_number": "859-971-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S 2ND ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221804",
            "telephone_number": "859-236-5302",
            "fax_number": "859-236-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "MARK",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "40350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100006290",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrunner30597@bhkydirect.com",
            "affiliation": "N",
            "address_1": "1740 Nicholasville Rd",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405031431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.