Individual provider Active NPI

Laura J Debruin, D.P.T.

  • Physical Therapist
  • Springfield, MA
National Provider Identifier
1215158522
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00756 Issued in CT
Practice address
1150 W Columbus Ave
Suite 3
Springfield, MA 01105-2502
Phone
(413) 241-8900
Fax
(413) 241-8901
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00756 CT Primary

Addresses

Primary practice location

1150 W Columbus Ave
Suite 3
Springfield, MA 01105-2502

Mailing address

37 Route 236
Suite 210
Kittery, ME 03904
UM
Phone (207) 439-2675

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090826000098 MA Practitioner - Physical Therapist in Private Practice 9234284365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Brimfield Way
Westfield, MA 01085-4383
Phone (413) 519-9531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00756CTMDAddiction (Substance Use Disorder) Counselor
007566CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Debruin Physical Therapy Physical Therapist CurrentSince Mar 18, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1215158522",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "37 ROUTE 236",
            "address_2": "SUITE 210",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "03904",
            "telephone_number": "207-439-2675",
            "fax_number": "207-439-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 W COLUMBUS AVE",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011052502",
            "telephone_number": "413-241-8900",
            "fax_number": "413-241-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRUIN",
        "first_name": "LAURA",
        "middle_name": "J",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "00756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.