SCOTT BRUDERER PA NPI 1003988205

Physician Assistant in Draper, UT

Individual Male Physician Assistant PECOS Enrolled Accepts Medicare Years Experience 19

About SCOTT BRUDERER

Scott Bruderer is a provider established in Draper, Utah and his medical specialization is physician assistant with more than 19 years of experience. The NPI number of Scott Bruderer is 1003988205 and was assigned on November 2006. The practitioner's primary taxonomy code is 363A00000X with license number 2828151206 (UT). The provider is registered as an individual and his NPI record was last updated January 2020. Scott Bruderer is enrolled in PECOS and is registered with Medicare and accepts claims assignment. According to Medicare claims data the provider has hospital affiliations with Lone Peak Hospital.

NPI

1003988205

Provider Name SCOTT BRUDERER PA
Provider Location Address96 E KIMBALLS LN STE 207 DRAPER, UT 84020
Provider Mailing AddressPO BOX 100253 ATLANTA, GA 30384
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2001
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date11-14-2006
Last Update Date01-20-2020

Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.2828151206
License StateUT
Taxonomy DescriptionA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Business Address

SCOTT BRUDERER PA
96 E KIMBALLS LN STE 207
DRAPER, UT
ZIP 84020
Phone: (801) 576-2300

Get Directions

Mailing Address

SCOTT BRUDERER PA
PO BOX 100253
ATLANTA, GA
ZIP 30384
Phone:

Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare’s enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID4385660653
PECOS Enrollment IDI20051017000899
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
Part B Clinical Laboratory and ImagingYes
Durable Medical EquipmentYes
Home Health Agency (HHA)Yes
Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 17Repair of knee joint (HCPCS:27447)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affilition the clinician must have provided services to at least three patients on three different dates in the last 12 months.

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN)
LONE PEAK HOSPITAL11925 SOUTH STATE STREET
DRAPER, UT 84020
Acute Care Hospitals460060

Other Providers at the same location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1144369935 TRASKE MCNEIL MUIR M.D.
Individual
Orthopaedic Surgery96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300
1447204821 STUART C MARSHALL JR. MD
Individual
Orthopaedic Surgery96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300
1447329164MR. PATRICK BARNES P.A.
Individual
Physician Assistant (Medical)96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300
1528124815 CHARLES L. BECK JR. M.D.
Individual
Orthopaedic Surgery (Sports Medicine)96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300
1770635245 ROBERT WILLIAM TOWNSLEY PA
Individual
Physician Assistant (Surgical)96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300
1841517257DR. SPENCER HAYDEN AMUNDSEN M.D.
Individual
Orthopaedic Surgery96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300
1902092133DR. ANDREA JENSEN MATICH M.D.
Individual
Family Medicine (Sports Medicine)96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300
1932458619 DAVID GERALD TRANTER PA-C
Individual
Physician Assistant (Surgical)96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 568-5972
1992923874DR. RICHARD BRIAN MACKEY MD
Individual
Orthopaedic Surgery96 E KIMBALLS LN STE 207
DRAPER, UT 84020
(801) 576-2300

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.