Sebastian Brunning

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA201741 Issued in OR

Practice address

1435 G St
Springfield, OR 97477-4113

Phone

(541) 735-9420

Fax

(541) 747-9870

NPI assigned

Jul 3, 2020

Last updated

Feb 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

G Street Integrated HealthGroup PAC ID 6800126145, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• G Street Integrated Health

  • Clinic/Center
  • Springfield, OR
  • NPI 1730734161
  Medicare reassignment Care Compare group
• Serenity Lane

  • Substance Abuse Rehabilitation Facility
  • Coburg, OR
  • NPI 1467283069
  NPD (past)

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1205453420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774113",
            "telephone_number": "541-735-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774113",
            "telephone_number": "541-735-9420",
            "fax_number": "541-747-9870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Serenity Ln",
            "address_purpose": "LOCATION",
            "city": "Coburg",
            "state": "OR",
            "postal_code": "974089350",
            "country_code": "US",
            "telephone_number": "541-687-1110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNNING",
        "first_name": "SEBASTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-03",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA201741",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Anne Brown, RN
• Crystal Annamarie Bruce, QMHA-R
• Cortney Brummond, M.S. CCC-SLP
• Richard Ea Brunader, M.D.
• Erin Nicole Bruni, MAT
• Ashley Bryson, MD
• Barbara L Bryson, FNP
• Krista Marie Bryson
• Justin John Bucci, MD
• Nicole Buchness, M.A.

• Medical Physician Assistant in Springfield, OR
• Providers in Springfield, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.