Individual provider Active NPI

Adrianus J Deruijter, MD

  • Psychiatry Physician
  • Brandon, FL
National Provider Identifier
1144394800
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME0058569 Issued in FL
Practice address
1427 Oakfield Dr
Brandon, FL 33511-2801
Phone
(813) 685-0500
Fax
(813) 681-8675
NPI assigned
Nov 17, 2006
Last updated
May 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME0058569 FL Primary

Addresses

Primary practice location

1427 Oakfield Dr
Brandon, FL 33511-2801

Mailing address

224 S. Moon Avenue
Brandon, FL 33511
Phone (813) 685-0500

Other identifiers 2

IdentifierTypeStateIssuer
056277700MedicaidFL
11396OtherFLBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000170 FL Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 7214028422 Reassigns benefits to 1 organization
Practice locations: Brandon, FL

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Health Sciences of West Florida LLCGroup PAC ID 3173700937, 3 clinicians

Practice addresses (Care Compare)

119 Oakfield Dr
Brandon, FL 33511-5779
Phone (813) 681-5551

5731 Bee Ridge Rd
Sarasota, FL 34233-5056
Phone (941) 342-4461

615 Vonderburg Dr
Brandon, FL 33511-5972
Phone (813) 685-0500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
81.63
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0058569FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Sciences of West Florida LLC Psychiatry CurrentSince Jan 1, 2015 Accepting new patients

Locations

1427 Oakfield Dr
Brandon, FL 33511
Phone (813) 684-5048

224 S Moon Ave
Brandon, FL 33511
Phone (813) 685-0500

615 Vonderburg Dr
Brandon, FL 33511
Phone (813) 421-4663

5731 Bee Ridge Rd
Sarasota, FL 34233
Phone (888) 221-2216

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: adrianus.deruijter@hca4.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1144394800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 S. MOON AVENUE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-685-0500",
            "fax_number": "813-681-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335112801",
            "telephone_number": "813-685-0500",
            "fax_number": "813-681-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUIJTER",
        "first_name": "ADRIANUS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0058569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056277700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "11396",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.