MR. JACK MICHAEL BRUNSON PA-C
NPI 1174950661
Physician Assistant in Elgin, IL

Q: What is Jack Brunson's NPI number?

The NPI number for Jack Brunson is 1174950661. It was assigned to this individual provider in the NPPES registry on September 30, 2013.

Q: What is Jack Brunson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Brunson was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 30, 2013PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1425 N RANDALL RD, ELGIN, IL 60123(847) 742-9800 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 24, 2025, Mar 22, 2019, Sep 14, 2017 (3 updates tracked since 2017).

On this page

About Mr. Jack Michael Brunson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACK MICHAEL BRUNSON PA-C (NPI 1174950661) is an individual physician assistant in Elgin, Illinois, licensed in Illinois (085.004840) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS, is affiliated with Advocate Condell Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1174950661

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. JACK MICHAEL BRUNSONCredential: PA-C

Location Address1425 N RANDALL RDElgin, IL 60123-2300

Mailing Address6552 N Oxford AveChicago, IL 60631-1529 · (941) 321-9790

Phone(847) 742-9800

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateSeptember 30, 2013

Last NPPES UpdateNovember 24, 20253 updates tracked since enumeration

NPPES CertifiedNovember 24, 2025

✔ NPI 1174950661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in IL · 085.004840✔ Licensed in IN · 10002688A✔ Licensed in WI · 853623

Definition

A 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.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 085004840 (IL)

1425 N RANDALL RD, Elgin, IL 60123

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Jack Michael Brunson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799911822

PECOS Enrollment IDI20251110000140

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

189 services184 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

71 services71 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

25 services25 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Condell Medical Center

Acute Care Hospitals · Libertyville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140202

Location801 S Milwaukee AveLibertyville, IL 60048 · Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

94.69

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TONIA C HANSON PA-C

Physician Assistant

1425 N RANDALL RD, SUITE 404
ELGIN, IL 60123

Kane County (224) 783-8129

NICOLE CARPENTER

Counselor (Mental Health)