NPIMap

Individual provider Active NPI

Kevin John Bruen, M.D.

  • Vascular Surgery Physician
  • Billings, MT
National Provider Identifier
1427221886
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
12351 Issued in MT
Practice address
2900 12TH Ave N
Suite 400E
Billings, MT 59101-7506
Phone
(406) 238-6820
Fax
(406) 238-6838
NPI assigned
Apr 8, 2008
Last updated
Sep 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5426453-1205 UT
Vascular Surgery Physician 2086S0129X 12127 FL
Vascular Surgery Physician 2086S0129X 12351 MT Primary

Addresses

Primary practice location

2900 12TH Ave N
Suite 400E
Billings, MT 59101-7506

Mailing address

2900 12TH Ave N
Suite 400E
Billings, MT 59101-7506
Phone (406) 238-6820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100902000337 MT Practitioner - Vascular Surgery 3072637792 Reassigns benefits to 2 organizations
I20150924002486 WY Practitioner - Vascular Surgery 3072637792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2900 12TH Ave N
Suite 400E
Billings, MT 59101-7514
Phone (406) 237-5770

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5426453-1205UTMDSurgery Physician
12127FLMDVascular Surgery Physician
12351MTMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group - Billings, LLC CurrentSince Mar 1, 2015 Accepting new patients
SCL Health Montana Current Accepting new patients
SCL Health Montana CurrentSince Mar 18, 2013 Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Mar 1, 2015 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1041 N 29th St
Billings, MT 59101
Phone (303) 237-5577

1233 N 30th St
Ofc
Billings, MT 59101

2019 Broadwater Ave
Billings, MT 59102
Phone (406) 237-5200

2900 12th Ave N
Ste 305A
Billings, MT 59101
Phone (406) 238-6820

2900 12th Ave N
Ste 400E
Billings, MT 59101
Phone (406) 238-6650

711 W Main St
Bozeman, MT 59715
Phone (406) 237-5050

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

1025 9th St
Cody, WY 82414
Phone (307) 578-2955

Interoperability endpoints

  • Direct secure messaging: kbruen33283@direct.intermountainhealth.org

Organizations & group practices 5

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 8

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": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1427221886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 400E",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-238-6820",
            "fax_number": "406-238-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N",
            "address_2": "SUITE 400E",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017506",
            "telephone_number": "406-238-6820",
            "fax_number": "406-238-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUEN",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "5426453-1205",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "12127",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MT",
            "license": "12351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.