Active NPI
Robert J Debruin, M.D.
- Internal Medicine Physician
- Folsom, CA
National Provider Identifier
1073507786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G42656
- Practice address
- 1600 Creekside Dr
Suite 3800
Folsom, CA 95630-3444 - Phone
- (916) 984-7830
- Fax
- (916) 984-7887
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G42656 | CA | Primary |
Addresses
Primary practice location
1600 Creekside Dr
Suite 3800
Folsom, CA 95630-3444
Mailing address
1600 Creekside Dr
Suite 3800
Folsom, CA 95630-3444
Phone (916) 984-7830
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G426560 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100616000480 | CA | Practitioner - Internal Medicine | 3779623319 | Practice locations: Folsom, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Florida College of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1600 Creekside Dr
Suite 3800
Folsom, CA 95630-3483
Phone (916) 984-7830
Hospital & facility affiliations
- Healing Touch Home Health Care Inc
- American River Home Care
- Progressive Home Care - Auburn
- Mercy Home Health
- Sutter Roseville Medical Center
- Mercy Hospital of Folsom
- Sutter Medical Center, Sacramento
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 208 |
| Removal or shaving of skin growth | 11 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42656 | CA | MD | Licensed Psychiatric Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Hill Physicians Medical Group - PPO Program | Past | Accepting new patients |
Interoperability endpoints
- rdebruin5778@hpmg.direct-ci.net
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Preferred Provider Organization
- San Ramon, CA
- NPI 1679011035
-
dba Sutter Solano Medical Center
- General Acute Care Hospital
- Vallejo, CA
- NPI 1366686248
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Sacramento, CA
- NPI 1811317811
-
dba Progressive Home Care - Auburn
- Home Health Agency
- Auburn, CA
- NPI 1396770269
-
- Home Health Agency
- Rancho Cordova, CA
- NPI 1962957720
-
dba Sutter Roseville Medical Center
- General Acute Care Hospital
- Roseville, CA
- NPI 1356390264
-
- General Acute Care Hospital
- Sacramento, CA
- NPI 1811946734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073507786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 CREEKSIDE DR",
"address_2": "SUITE 3800",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956303444",
"telephone_number": "916-984-7830",
"fax_number": "916-984-7887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CREEKSIDE DR",
"address_2": "SUITE 3800",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956303444",
"telephone_number": "916-984-7830",
"fax_number": "916-984-7887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBRUIN",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G42656",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G426560",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Folsom, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.