Individual provider Active NPI

Joseph De Bruin, D.C.

  • Chiropractor
  • Scottsdale, AZ
National Provider Identifier
1154306744
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
04459 Issued in AZ
Practice address
8010 E McDowell Rd
123
Scottsdale, AZ 85257-3867
Phone
(480) 946-4476
Fax
(480) 946-3024
NPI assigned
Dec 7, 2005
Last updated
Aug 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 04459 AZ Primary

Addresses

Primary practice location

8010 E McDowell Rd
123
Scottsdale, AZ 85257-3867

Mailing address

8010 E McDowell Rd
123
Scottsdale, AZ 85257-3867
Phone (480) 946-4476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070716000220 AZ Practitioner - Chiropractic 4385744614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8010 E McDowell Rd
Suite 123
Scottsdale, AZ 85257-3869
Phone (480) 946-4476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04459AZMDChiropractor
4459AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Arizona LLC CurrentSince Feb 1, 2018 Accepting new patients
De Bruin Chiropractic LTD Chiropractor CurrentSince Jul 2, 2007 Accepting new patients

Locations

14200 W Celebrate Life Way
Goodyear, AZ 85338
Phone (623) 207-3000

8010 E McDowell Rd
Ste 123
Scottsdale, AZ 85257
Phone (480) 946-4476

6897 Paysphere Cir
Chicago, IL 60674
Phone (480) 586-7542

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1154306744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 E MCDOWELL RD",
            "address_2": "123",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573867",
            "telephone_number": "480-946-4476",
            "fax_number": "480-946-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 E MCDOWELL RD",
            "address_2": "123",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573867",
            "telephone_number": "480-946-4476",
            "fax_number": "480-946-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BRUIN",
        "first_name": "JOSEPH",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "04459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.