NICOLE RENEE BRUNAUGH NP
NPI 1750958351
Nurse Practitioner - Gerontology in Alton, IL
About Nicole Renee Brunaugh Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE RENEE BRUNAUGH NP (NPI 1750958351) is an individual gerontology provider in Alton, Illinois, licensed in Illinois (209022501) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Nicole Renee Brunaugh Np 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.
Medicare Billing Reassignments
6Medicare enrollment records show Nicole Brunaugh reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Oak Brook, IL 60523
- Reassigned Medicare billing, Illinois enrollment
- 67 clinicians in this Medicare group
Festus, MO 63028
- Reassigned Medicare billing, Illinois enrollment
- 14 clinicians in this Medicare group
Saint Louis, MO 63136
- Reassigned Medicare billing, Illinois enrollment
- 22 clinicians in this Medicare group
Saint Louis, MO 63136
- Reassigned Medicare billing, Illinois enrollment
- Medicare enrollment name: Midwest Anesthesia Providers Sc
- 253 clinicians in this Medicare group
Shiloh, IL 62269
- Reassigned Medicare billing, Illinois enrollment
- 3 clinicians in this Medicare group
Skokie, IL 60076
- Reassigned Medicare billing, Illinois enrollment
- 491 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62002 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Nicole Brunaugh's NPI number?
The NPI number for Nicole Brunaugh is 1750958351. It was assigned to this individual provider in the NPPES registry on June 10, 2021.
Where is Nicole Brunaugh located?
Nicole Brunaugh practices at #2 Memorial Dr. Suite 103, Alton, IL 62002. The listed phone number is (618) 463-7246.
What is Nicole Brunaugh's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Nicole Brunaugh enrolled in Medicare?
Yes. Nicole Brunaugh is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Nicole Brunaugh's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Brunaugh reassigns Medicare benefits to 6 organizations: Applebaum Physiatry PLLC (Oak Brook, IL), Interventional Pain Institute, LLC (Festus, MO), Midwest Anesthesia Associates, P.C. (Saint Louis, MO), Midwest Anesthesia Providers S.C (Saint Louis, MO), Mitas LLC (Shiloh, IL) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Brunaugh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Nicole Brunaugh was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Nicole Renee Brunaugh, NP · NPI 1750958351
Gerontology physician in Alton, Illinois. Individual provider, active in the CMS NPPES registry since June 10, 2021.
## Identity
- **NPI:** 1750958351 (Entity type: Individual)
- **Enumerated:** June 10, 2021
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 209022501 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** #2 MEMORIAL DR., SUITE 103, Alton, IL 62002-6723
- **Phone:** (618) 463-7246
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Applebaum Physiatry PLLC (NPI 1700598059, Oak Brook, IL); Interventional Pain Institute, LLC (NPI 1336461771, Festus, MO); Midwest Anesthesia Associates, P.C. (NPI 1558719617, Saint Louis, MO); Midwest Anesthesia Providers S.C (NPI 1295189082, Saint Louis, MO); Mitas LLC (NPI 1659967917, Shiloh, IL); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** October 14, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1750958351) · Data from the CMS NPPES public registry.