Peter Brukasz, M.D.

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

036111722 Issued in IL

Practice address

10510 S Roberts Rd
Palos Hills, IL 60465-1934

Phone

(630) 401-7102

Fax

(630) 566-6879

NPI assigned

Nov 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Piotr Brukasz Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Internal Medicine

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Institute for Vein Health LLC

  • Phlebology Physician
  • Addison, IL
  • NPI 1619412574
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1396728978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651934",
            "telephone_number": "630-401-7102",
            "fax_number": "630-566-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651934",
            "telephone_number": "630-401-7102",
            "fax_number": "630-566-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUKASZ",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IL",
            "license": "036111722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01621679",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PIOTR",
            "last_name": "BRUKASZ",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Marie Breier
• Matt Breiner, MA, QMHP
• Beverlee A Brisbin, MD
• Jamilah Brown, LSW
• Bruce Total Wellness LLC
• Katarzyna Barbara Bundyra
• Verally Azucena Calderon, LCSW
• Monica Caldwell
• Lisa Michelle Calloway, LCSW
• Victoria Carbonell

• Phlebology Physician in Palos Hills, IL
• Providers in Palos Hills, IL by specialty
• Phlebology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.