Mark Ike Debruin, DO is a medicare enrolled "Family Medicine" physician in Orangevale, California. He went to Midwestern University, Chicago College Of Osteopathic Med and graduated in 1988 and has 36 years of diverse experience with area of expertise as Family Practice. His current practice location is
9352 Madison Ave, Ste 1, Orangevale, California. You can reach out to his office (for appointments etc.) via phone at
(916) 989-2929.
Mark Ike Debruin is licensed to practice in California (license number 20A5579) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1154327518.
Physician's Profile
| Full Name | Mark Ike Debruin |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 36 Years |
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| Location | 9352 Madison Ave, Orangevale, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mark Ike Debruin attended and graduated from Midwestern University, Chicago College Of Osteopathic Med in 1988
NPI Data:
- NPI Number: 1154327518
- Provider Enumeration Date: 06/21/2005
- Last Update Date: 09/18/2012
Medicare PECOS Information:
- PECOS PAC ID: 2567523681
- Enrollment ID: I20081212000345
Medical Identifiers
Medical identifiers for Mark Ike Debruin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1154327518 | NPI | - | NPPES |
| 00AX55790 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 20A5579 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mark Ike Debruin allows following entities to bill medicare on his behalf.
| Entity Name | Debruin Medical Center A Prof Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104095975
PECOS PAC ID: 8022179142
Enrollment ID: O20081209000025 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark Ike Debruin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mark Ike Debruin, DO
9352 Madison Ave, Ste 1,
Orangevale, CA 95662-4968
Ph: (916) 989-2929 | Mark Ike Debruin, DO
9352 Madison Ave, Ste 1,
Orangevale, CA 95662-4968
Ph: (916) 989-2929 |
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