Dave R Brumbaugh, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

388 Issued in WY

Practice address

1909 Vista Dr
Laramie, WY 82070-5530

Phone

(307) 745-8851

Fax

(307) 742-0961

NPI assigned

Jan 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Rio Blanco County Health Service DistrictGroup PAC ID 0345249751, shared by 5 NPIs, 41 clinicians

Orthopaedics of Jackson Hole PCGroup PAC ID 9436042322, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Johns Medical Center Hospital, Jackson, WY, CCN 530015
• Eastern Rio Blanco County Health Service District Hospital, Meeker, CO, CCN 061325

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Orthopaedics of Jackson Hole PC

  dba Teton Orthopaedics

  • Orthopaedic Surgery Physician
  • Jackson, WY
  • NPI 1336221712
  Medicare reassignment Care Compare group
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  Medicare reassignment NPD
• Gem City Bone & Joint PC

  • Orthopaedic Surgery Physician
  • Laramie, WY
  • NPI 1366412397
  NPD
• Gem City Bone & Joint PC

  • Durable Medical Equipment & Medical Supplies
  • Laramie, WY
  • NPI 1952441164
  NPD

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

• Teton County Hospital District

  dba St John's Medical Center/ or St John's Health

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  Care Compare affiliation
• Eastern Rio Blanco County Health Service District

  dba Pioneers Medical Center

  • Critical Access Hospital
  • Meeker, CO
  • NPI 1801874771
  Care Compare affiliation

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114907722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 VISTA DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705530",
            "telephone_number": "307-745-8851",
            "fax_number": "307-742-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 VISTA DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705530",
            "telephone_number": "307-745-8851",
            "fax_number": "307-742-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBAUGH",
        "first_name": "DAVE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WY",
            "license": "388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6826364",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Kay Brown, PMHNP-BC
• Tanya Brown
• Jacob Brownell
• David Bruch
• Holly Bruch, M.S., CCC-SLP
• Amanda Brumbles
• Jacqueline Bruner
• Rachael Lee Bruyere, RMT
• Sarah Buche
• Tiffany Bullock

• Surgical Physician Assistant in Laramie, WY
• Providers in Laramie, WY by specialty
• Surgical Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.