NPIMap

Individual provider Active NPI

David Elliott De Bruin, M.D.

  • Diagnostic Radiology Physician
  • Iowa City, IA
National Provider Identifier
1508062837
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036132363 Issued in IL
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-1616
NPI assigned
Jun 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036132363 IL Primary
Diagnostic Radiology Physician 2085R0202X 4301103333 MI
Diagnostic Radiology Physician 2085R0202X R-9341 IA

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130828000097 IL Practitioner - Diagnostic Radiology 9537308051 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Sinai Community FoundationGroup PAC ID 5991600405, 247 clinicians
St Bernard HospitalGroup PAC ID 1759361579, 43 clinicians
Loretto HospitalGroup PAC ID 5193725893, 38 clinicians

Practice addresses (Care Compare)

1401 S California Ave
Chicago, IL 60608-1858
Phone (773) 522-6656

2701 W 68TH St
Chicago, IL 60629-1813
Phone (773) 884-9000

326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-3900

645 S Central Ave
Chicago, IL 60644-5059
Phone (773) 854-5567

California Ave at 15TH St
Chicago, IL 60608-1858
Phone (773) 542-2000

Hospital & facility affiliations

  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018
  • Holy Cross Hospital Hospital, Chicago, IL, CCN 140133
  • St Bernard Hospital Hospital, Chicago, IL, CCN 140103
  • Loretto Hospital Hospital, Chicago, IL, CCN 140083

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
71.53
Promoting interoperability
100
Improvement activities
40
Cost
76.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036132363ILMDDiagnostic Radiology Physician
4301103333MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince Aug 1, 2013 Accepting new patients
Loretto Hospital CurrentSince Jul 1, 2022 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Cook County Current Accepting new patients
St Bernard Hospital Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Aug 1, 2013 Accepting new patients
St Bernard Hospital Diagnostic Radiology CurrentSince Mar 1, 2021 Accepting new patients
Cook County Diagnostic Radiology CurrentSince Mar 7, 2024 Accepting new patients
St Bernard Hospital & Health Care Center CurrentSince Mar 1, 2021 Accepting new patients
Cook County CurrentSince Mar 7, 2024 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

645 S Central Ave
Chicago, IL 60644
Phone (773) 626-4300

326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900

4701 W Cermak Rd
Cicero, IL 60804
Phone (708) 391-8300

Organizations & group practices 10

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 7

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": "1182643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1508062837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BRUIN",
        "first_name": "DAVID",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-24",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036132363",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301103333",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "R-9341",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.