NPIMap

Individual provider Active NPI

Brian Keith Rundall, D.O.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Greenville, SC
National Provider Identifier
1841217585
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
83753 Issued in SC
Practice address
890 W Faris Rd Ste 320
Greenville, SC 29605-4281
Phone
(864) 455-1200
Fax
(864) 455-1209
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X DO-04423 IA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 307379 NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 83753 SC Primary

Addresses

Primary practice location

890 W Faris Rd Ste 320
Greenville, SC 29605-4281

Mailing address

300 E McBee Ave Ste 401
Greenville, SC 29601-2842
Phone (864) 522-8602

Other practice location 1

Elm and Carlton Streets
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other practice location 2

1215 Pleasant St
Ste 618
Des Moines, IA 50309
Phone (515) 875-9090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211119001803 SC Practitioner - Thoracic Surgery 7214125210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

890 W Faris Rd
Suite 320
Greenville, SC 29605-4281
Phone (864) 455-1200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-04423IAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
83753SCMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Nov 15, 2021 Accepting new patients
Prisma Health University Medical Group CurrentSince Nov 15, 2021 Accepting new patients
East Falls Cardiovascular and Thoracic Surgery, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

890 W Faris Rd
Ste 320
Greenville, SC 29605
Phone (864) 455-1200

300 E McBee Ave
Ste 401
Greenville, SC 29601

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

Interoperability endpoints

  • Direct secure messaging: brundall536753@direct.ghs.myhfn.org

Organizations & group practices 4

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 57

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1841217585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 401",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W FARIS RD STE 320",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054281",
            "telephone_number": "864-455-1200",
            "fax_number": "864-455-1209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Elm and Carlton Streets",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142630001",
            "country_code": "US",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-8518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Pleasant St",
            "address_2": "Ste 618",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "50309",
            "country_code": "US",
            "telephone_number": "515-875-9090",
            "fax_number": "515-241-5041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNDALL",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IA",
            "license": "DO-04423",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "307379",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "SC",
            "license": "83753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.