Michael Frederick De Bruin, M.D., M.P.H.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

78648 Issued in MA

Practice address

VA Outpatient Clinic
605 Lincoln Street
Worcester, MA 01605-1901

Phone

(800) 865-3384

Fax

(508) 856-7425

NPI assigned

Jun 10, 2006

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

Medicare fee-for-service enrollment

Enrolled in MA

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

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255824000000",
    "number": "1780625434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VA OUTPATIENT CLINIC",
            "address_2": "605 LINCOLN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051901",
            "telephone_number": "800-865-3384",
            "fax_number": "508-856-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA OUTPATIENT CLINIC",
            "address_2": "605 LINCOLN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051901",
            "telephone_number": "800-865-3384",
            "fax_number": "508-856-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BRUIN",
        "first_name": "MICHAEL",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2009-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "78648",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "78648",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Dawson, ATC
• Elizabeth Day
• Jessica Nicholas Day, NP-C
• Utkarsh Dayal
• Matthew C. Dayno, MD
• Thiffany De Castro
• Colleen De Cesare, BCBA
• Velmar Y De Jesus
• Gabriel Antonio De la Cruz Ku, MD
• Wanderis De la Cruz

• Internal Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2009; 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.