Individual provider Active NPI

Kevin R Runge, PA

  • Medical Physician Assistant
  • Burr Ridge, IL
National Provider Identifier
1336135680
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-002433 Issued in IL
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

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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, NM3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20051028000085 IL Practitioner - Physician Assistant 4486671500 Reassigns benefits to 1 organization
I20251007003538 AZ Practitioner - Physician Assistant 4486671500 Reassigns benefits to 1 organization
I20251124003774 NM Practitioner - Physician Assistant 4486671500 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
10955AZMDProfessional Counselor
085-002433ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC CurrentSince Jul 30, 2025 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

Sources for this page

Verify at the official NPI Registry.