Individual provider Active NPI

Paul T Brungardt

  • Hospitalist Physician
  • Saint Joseph, MO
National Provider Identifier
1386107936
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2022034945 Issued in MO
Practice address
5325 Faraon St
Saint Joseph, MO 64506-3488
Phone
(816) 271-6406
Fax
(816) 271-7986
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2022034945 MO
Hospitalist Physician 208M00000X 2022034945 MO Primary

Addresses

Primary practice location

5325 Faraon St
Saint Joseph, MO 64506-3488

Mailing address

5301 Faraon St Ste 120
Saint Joseph, MO 64506-3512
Phone (816) 271-6406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923002297 MO Practitioner - Internal MedicinePractitioner - Hospitalist 1254668445 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Kansas School of Med (KC/Wich/Sal), 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

5202 Faraon St
Suite a
Saint Joseph, MO 64506-3840
Phone (816) 271-1067

5301 Faraon St
Saint Joseph, MO 64506-3512
Phone (816) 271-7546

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-3500

901 Heartland Rd
Saint Joseph, MO 64506-6201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022034945MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Center Association Inc CurrentSince Apr 13, 2024 Accepting new patients
Heartland Regional Medical Center Internal Medicine CurrentSince Sep 28, 2022 Accepting new patients
Heartland Regional Medical Center CurrentSince Sep 28, 2022 Accepting new patients
Mosaic Medical Center - Maryville Internal Medicine CurrentSince Aug 22, 2023 Accepting new patients
Northwest Medical Center Association Inc CurrentSince Apr 13, 2024 Accepting new patients
Heartland Regional Medical Center Internal Medicine Current Accepting new patients
Mosaic Medical Center - Maryville CurrentSince Aug 22, 2023 Accepting new patients
Mosaic Medical Center - Maryville Past Accepting new patients
Heartland Regional Medical Center Past Accepting new patients

Locations

705 N College St
Albany, MO 64402
Phone (660) 726-3941

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1213

5301 Faraon St
Ste 120
Saint Joseph, MO 64506
Phone (816) 271-6406

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1386107936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 FARAON ST STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063512",
            "telephone_number": "816-271-6406",
            "fax_number": "816-271-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6406",
            "fax_number": "816-271-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNGARDT",
        "first_name": "PAUL",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2022034945",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2022034945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.