Kyle Brunner, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Providence, Rhode Island. His current practice location is
593 Eddy St, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at
(401) 793-2695.
Kyle Brunner is licensed to practice in Rhode Island (license number LP06155) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1548951387.
Physician's Profile
Full Name | Kyle Brunner |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 593 Eddy St, Providence, Rhode Island |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1548951387
- Provider Enumeration Date: 05/15/2023
- Last Update Date: 06/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 9931565421
- Enrollment ID: I20230526000023
Medical Identifiers
Medical identifiers for Kyle Brunner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548951387 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | MT228119 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | LP06155 (Rhode Island) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kyle Brunner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kyle Brunner, MD 593 Eddy St, Providence, RI 02903-4923 Ph: () - | Kyle Brunner, MD 593 Eddy St, Providence, RI 02903-4923 Ph: (401) 793-2695 |
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