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DR. TIMOTHY J DERUYTER DDS
NPI 1487810800
Dentist - General Practice in Goldsboro, NC

Active since August 05, 2008PECOS Enrolled
1050 JABARA AVE, SEYMOUR JOHNSON AFB, GOLDSBORO, NC 27531(919) 722-1933 Get Directions Write a Review

NPPES record last updated: August 5, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Timothy J Deruyter Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIMOTHY J DERUYTER DDS (NPI 1487810800) is an individual general practice provider in Goldsboro, North Carolina, licensed in Pennsylvania (DS037574) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487810800
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. TIMOTHY J DERUYTERCredential: DDS
Location Address1050 JABARA AVE, SEYMOUR JOHNSON AFBGoldsboro, NC 27531-2310
Mailing Address1050 Jabara Ave, Seymour Johnson AfbGoldsboro, NC 27531-2310 · (919) 722-1933
Phone(919) 722-1933
Sole ProprietorNo
Enumeration DateAugust 5, 2008
✔ NPI 1487810800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in PA · DS037574
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1050 JABARA AVE, Goldsboro, NC 27531
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy J Deruyter Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27531 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILBUR W ALBERTSON
Psychologist (Clinical)
1050 JABARA AVE, SEYMOUR JOHNSON AFB
GOLDSBORO, NC 27531
Wayne County (919) 722-0928
DAVID VINCENT PETER ESPITIA
Military Health Care Provider (Independent Duty Medical Technicians)
1050 JABARA AVE
GOLDSBORO, NC 27531
Wayne County (919) 722-1904
LYNDON JOHNSON RN
Registered Nurse (Ambulatory Care)
1050 JABARA AVE
GOLDSBORO, NC 27531
Wayne County (919) 722-1802
MR. GARY L POLAND
Optometrist
1050 JABARA AVE, SEYMOUR JOHNSON AFB
GOLDSBORO, NC 27531
Wayne County (919) 722-0928
DR. TOD S RUSSELL M.D.
Pediatrics (Pediatric Infectious Diseases)
1050 JABARA AVE, SEYMOUR JOHNSON AFB
GOLDSBORO, NC 27531
Wayne County (919) 722-0928
DR. ELLIOTT JOHN SALLY DO
Pediatrics
1050 JABARA AVE, SJAFB, PEDIATRIC CLINIC
GOLDSBORO, NC 27531
Wayne County (919) 722-1536
MR. WILSON ANDREW HARRIS III MS, RDN, CSSD, LDN
Dietitian, Registered
1050 JABARA AVE
SEYMOUR JOHNSON A F B, NC 27531
Wayne County (919) 722-0407
ELIZABETH GMINSKI DNP, NP-C
Nurse Practitioner (Family)
1050 JABARA AVE
SEYMOUR JOHNSON A F B, NC 27531
Wayne County (919) 722-1802

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Deruyter's NPI number?

The NPI number for Timothy Deruyter is 1487810800. It was assigned to this individual provider in the NPPES registry on August 5, 2008.

Where is Timothy Deruyter located?

Timothy Deruyter practices at 1050 Jabara Ave Seymour Johnson Afb, Goldsboro, NC 27531. The listed phone number is (919) 722-1933.

What is Timothy Deruyter's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Timothy Deruyter enrolled in Medicare?

Yes. Timothy Deruyter is registered in the Medicare PECOS enrollment system.

What insurance does Timothy Deruyter accept?

Health plans from Anthem Blue Cross and Blue Shield list Timothy Deruyter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Timothy Deruyter was last updated on August 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.