DR. BRAD L SUPRENANT DO
NPI 1760467377
Internal Medicine - Clinical Cardiac Electrophysiology in Kankakee, IL

Q: What is Brad Suprenant's NPI number?

The NPI number for Brad Suprenant is 1760467377. It was assigned to this individual provider in the NPPES registry on December 7, 2005.

Q: What is Brad Suprenant's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Clinical Cardiac Electrophysiology, with taxonomy code 207RC0001X.

Q: When was this NPI record last updated?

The NPPES record for Brad Suprenant was last updated on March 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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 December 07, 2005PECOS Enrolled

500 N WALL ST, KANKAKEE, IL 60901(844) 404-4787(815) 936-3243 Get Directions Write a Review

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 29, 2021, Jul 8, 2020, Jul 25, 2019 (3 updates tracked since 2019).

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About Dr. Brad L Suprenant Do NPPES

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

DR. BRAD L SUPRENANT DO (NPI 1760467377) is an individual clinical cardiac electrophysiology provider in Kankakee, Illinois, licensed in Illinois (036071427) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1760467377

Entity TypeIndividualMale

Primary Taxonomy207RC0001X

Provider Legal NameDR. BRAD L SUPRENANTCredential: DO

Location Address500 N WALL STKankakee, IL 60901-2942

Mailing Address500 N Wall StKankakee, IL 60901-2942 · (844) 404-4787 · Fax (815) 936-3243

Phone(844) 404-4787

Fax(815) 936-3243

Sole ProprietorNo

Enumeration DateDecember 7, 2005

Last NPPES UpdateMarch 29, 20213 updates tracked since enumeration

NPPES CertifiedMarch 29, 2021

✔ NPI 1760467377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Clinical Cardiac ElectrophysiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RC0001X

Licenses✔ Licensed in IL · 036071427✔ Licensed in IN · 02001098A

Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.

500 N WALL ST, Kankakee, IL 60901

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Secondary Practice Locations 2

Location 1375 N Wall St Ste P420Kankakee, IL 60901 · Phone (815) 939-9400 · Fax (815) 939-9494

Location 21490 E Walnut St Ste AWatseka, IL 60970-1806 · Phone (815) 432-7693 · Fax (815) 936-7228

Other Identifiers 3

Medicaid036071247IL

Other060030169Rr Medicare

Other000000095316IN · Anthem Pin

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Brad L Suprenant Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Brad Suprenant reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Riverside Health System

Same address

Psychiatry

500 N WALL ST, SUITE 200
Kankakee, IL 60901

Reassigned Medicare billing, Illinois enrollment
381 clinicians in this Medicare group

NPI 1336354430 (815) 937-1237

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60901 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

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

Other Providers at the Same Location NPPES 17

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

ANUJA GUPTA MD

Pediatrics (Pediatric Cardiology)

500 N WALL ST, SUITE 100
KANKAKEE, IL 60901

Kankakee County (815) 933-2557

DR. LYNN G BROWN MD

Internal Medicine (Cardiovascular Disease)

500 N WALL ST
KANKAKEE, IL 60901

Kankakee County (844) 404-4787

MR. ANDREW J DONOFRIO PA-C

Physician Assistant

500 N WALL ST
KANKAKEE, IL 60901

Kankakee County (844) 404-4787

KENDRA G HANSEN ANP-BC

Nurse Practitioner (Adult Health)

500 N WALL ST
KANKAKEE, IL 60901

Kankakee County (844) 404-4787

SEBAN LIU D.O.

Internal Medicine (Cardiovascular Disease)

500 N WALL ST
KANKAKEE, IL 60901

Kankakee County (844) 404-4787

LYNN GAYE BROWN, M.D., S.C.

Specialist

500 N WALL ST, SUITE 201
KANKAKEE, IL 60901

Kankakee County (815) 932-2000

DR. SYED M HUSSAIN MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

500 N WALL ST
KANKAKEE, IL 60901

Kankakee County (844) 404-4787

ANDREW TARIAO MARIANO DO

Internal Medicine (Cardiovascular Disease)

500 N WALL ST
KANKAKEE, IL 60901

Kankakee County (844) 404-4787

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 Brad Suprenant's NPI number?

The NPI number for Brad Suprenant is 1760467377. It was assigned to this individual provider in the NPPES registry on December 7, 2005.

Where is Brad Suprenant located?

Brad Suprenant practices at 500 N Wall St, Kankakee, IL 60901. The listed phone number is (844) 404-4787.

What is Brad Suprenant's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Clinical Cardiac Electrophysiology, with taxonomy code 207RC0001X.

Is Brad Suprenant enrolled in Medicare?

Yes. Brad Suprenant is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Brad Suprenant's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brad Suprenant reassigns Medicare benefits to Riverside Health System (Kankakee, IL). The 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 Brad Suprenant'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 Brad Suprenant was last updated on March 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.