Individual provider Active NPI

Abbey E Debruin, MD

  • Orthopaedic Surgery Physician
  • Green Bay, WI
National Provider Identifier
1366904666
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
75314 Issued in WI
Practice address
2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6238
Phone
(920) 430-8113
NPI assigned
Apr 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 75314 WI Primary

Addresses

Primary practice location

2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6238

Mailing address

2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6238
Phone (920) 430-8113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250723000819 WI Practitioner - Orthopedic Surgery 3476888454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Wisconsin School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6238
Phone (920) 430-8113

5347 Main St
Suite 202
New Port Richey, FL 34652-2520
Phone (727) 841-0515

Hospital & facility affiliations

  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75314WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Medicine Specialists of Green Bay, SC Orthopaedic Surgery CurrentSince Sep 2, 2025 Accepting new patients

Locations

2223 Lime Kiln Rd
Ste 1
Green Bay, WI 54311
Phone (920) 468-0246

1931 Marinette Ave
Marinette, WI 54143
Phone (715) 735-5500

1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0cda6ed7-9e18-4112-ab11-d5a45a40c8d5/

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.

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1366904666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD STE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116238",
            "telephone_number": "920-430-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 LIME KILN RD STE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116238",
            "telephone_number": "920-430-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRUIN",
        "first_name": "ABBEY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "75314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.