Derick S Brubaker, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD417531 Issued in PA

Practice address

515B Hershey Ave
Lancaster, PA 17603-5752

Phone

(717) 299-6372

Fax

(717) 945-1587

NPI assigned

Jul 15, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1134458789
  Medicare reassignment NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1326656174
  NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1417812710
  NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Denver, PA
  • NPI 1578024196

  Family Medicine

  NPD
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1801853346
  NPD
• Community Services Group, Inc.

  • Community/Behavioral Health Agency
  • Mountville, PA
  • NPI 1265426084
  NPD (past)
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1366496416
  NPD (past)
• Union Community Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, PA
  • NPI 1538681283
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306862719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N WATER ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033374",
            "telephone_number": "717-735-6808",
            "fax_number": "717-945-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515B HERSHEY AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176035752",
            "telephone_number": "717-299-6372",
            "fax_number": "717-945-1587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Arch St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176032928",
            "country_code": "US",
            "telephone_number": "717-945-1559",
            "fax_number": "717-945-1587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 N Arch St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176032928",
            "country_code": "US",
            "telephone_number": "717-945-1559",
            "fax_number": "717-945-1587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "DERICK",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00041153",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD417531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8317182",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Titina Finch Brown, PSYD
• Christy Ann Brubaker, PTA
• Coby C Brubaker, BA
• Cynthia Brubaker, PAC
• Derek Glenn Brubaker
• Devon Elizabeth Brubaker, ATC
• Glen Roy Brubaker, M.D.
• Jay Kenneth Brubaker, M.D.
• Jennifer E Brubaker, M.D.
• Joellyn Elizabeth Brubaker, PTA

• Family Medicine Physician in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.