NPIMap

Individual provider Active NPI

Brian D Amundson, PA-C

  • Surgical Physician Assistant
  • Hinsdale, IL
National Provider Identifier
1275574469
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085002379 Issued in IL
Practice address
550 W Ogden Ave
Hinsdale, IL 60521-3186
Phone
(630) 323-6116
Fax
(630) 323-6169
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085002379 IL Primary

Addresses

Primary practice location

550 W Ogden Ave
Hinsdale, IL 60521-3186

Mailing address

550 W Ogden Ave
Hinsdale, IL 60521-3186
Phone (630) 323-6116

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bamundson105184@direct.luhs.org Health Information Exchange (HIE) LOYOLA UNIVERSITY MEDICAL CENTER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000855 IL Practitioner - Physician Assistant 0345143087 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085002379ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Mar 30, 2020 Accepting new patients
Hinsdale Orthopaedic Associates, SC CurrentSince Nov 11, 2019 Accepting new patients
Parkview Orthopaedic Group S C CurrentSince Sep 19, 2011 Accepting new patients
Loyola University Medical Center CurrentSince Mar 30, 2020 Accepting new patients
Parkview Orthopaedic Group S C CurrentSince Sep 19, 2011 Accepting new patients
Macneal Physicians Group LLC Past Accepting new patients

Locations

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

550 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 323-6116

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

688 Cedar Crossings Dr
New Lenox, IL 60451
Phone (815) 727-3030

7600 W College Dr
Palos Heights, IL 60463
Phone (708) 361-0600

Interoperability endpoints

  • Direct secure messaging: brian.amundson.p1@direct.parkviewortho.nextgenshare.com

Organizations & group practices 8

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 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1275574469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213186",
            "telephone_number": "630-323-6116",
            "fax_number": "630-323-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213186",
            "telephone_number": "630-323-6116",
            "fax_number": "630-323-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "BRIAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085002379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bamundson105184@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.