DEREK GLENN BRUBAKER
NPI 1629680889
Nurse Practitioner - Family in Lancaster, PA

Q: What is Derek Brubaker's NPI number?

The NPI number for Derek Brubaker is 1629680889. It was assigned to this individual provider in the NPPES registry on August 19, 2020.

Q: What is Derek Brubaker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Brubaker was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 19, 2020PECOS EnrolledAccepts Medicare Assignment

555 N DUKE ST, LANCASTER, PA 17602(717) 544-4995 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Derek Glenn Brubaker NPPES

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

DEREK GLENN BRUBAKER (NPI 1629680889) is an individual family provider in Lancaster, Pennsylvania, licensed in Pennsylvania (SP022377) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1629680889

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameDEREK GLENN BRUBAKER

Location Address555 N DUKE STLancaster, PA 17602-2250

Mailing Address539 W Walnut StLancaster, PA 17603-3337 · (717) 575-5087

Phone(717) 544-4995

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 19, 2020

Last NPPES UpdateNovember 27, 2023

NPPES CertifiedAugust 19, 2020

✔ NPI 1629680889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in PA · SP022377

555 N DUKE ST, Lancaster, PA 17602

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derek Glenn Brubaker is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789002957

PECOS Enrollment IDI20200921001556

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 17602 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

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 20

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

TYLER JOHNSTON MD

Family Medicine