Active NPI
Kevin R Runge, PA
- Medical Physician Assistant
- Burr Ridge, IL
National Provider Identifier
1336135680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 085-002433
- Practice address
- 901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0872 - Phone
- (888) 220-6432
- Fax
- (630) 654-4253
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085-002433 | IL | Primary |
Addresses
Primary practice location
901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0872
Mailing address
901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0872
Phone (888) 220-6432
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krunge283767@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, AZ, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1717 Main St
Suite 5850
Dallas, TX 75201-4681
1717 Main St
Suite 5850
Dallas, TX 75201-7317
27 W412 Chartwell Dr
Winfield, IL 60190-1806
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10955 | AZ | MD | Professional Counselor |
| 085-002433 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Telecare, PLLC | Current | Accepting new patients |
Locations
5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1336135680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 MCCLINTOCK DR",
"address_2": "SUITE 202",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605270872",
"telephone_number": "888-220-6432",
"fax_number": "630-654-4253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 MCCLINTOCK DR",
"address_2": "SUITE 202",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605270872",
"telephone_number": "888-220-6432",
"fax_number": "630-654-4253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNGE",
"first_name": "KEVIN",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085-002433",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "krunge283767@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "901 MCCLINTOCK DR",
"address_2": "SUITE 202",
"city": "BURR RIDGE",
"state": "IL",
"country_code": "US",
"postal_code": "605270872",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "901 MCCLINTOCK DR",
"address_2": "SUITE 202",
"city": "BURR RIDGE",
"state": "IL",
"country_code": "US",
"postal_code": "605270872",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Burr Ridge, IL
- Jordan Rosenblum, MD
- Robert L Rosenfield, MD
- Sarah Rossi, CCC-SLP
- Julie Marlane Rubin, M.D.
- Ruth R Rudinsky, MD
- Rush-Select Holdings, LLC. (RUSH Physical Therapy)
- S-H Opco Burr Ridge, LLC (Dimensions Living Burr Ridge)
- Sacred Touch Massage LLC. (sacred touch massage)
- Nishi B Sahgal, MD
- Alan Guillermo Salazar, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.