DR. BEVERLY ANN DE LA BRUERE
NPI 1720176332
Family Medicine - Addiction Medicine in Damascus, OR
NPI Status: Active since October 10, 2006
Contact Information
18151 SE HIGHWAY 212
DAMASCUS, OR
ZIP 97089
Phone: (503) 658-6022
Fax: (503) 658-7818
- Individual
- Female
- Family Medicine
- Addiction Medicine
- Accepts Insurance
- CLIA Number: 38D0621790
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-31-2025
About BEVERLY DE LA BRUERE
This page provides the complete NPI Profile along with additional information for Beverly De La Bruere, a provider established in Damascus, Oregon with a medical specialization in Family Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1720176332 assigned on October 2006. The practitioner's primary taxonomy code is 207QA0401X with license number MD15031 (OR). The provider is registered as an individual and her NPI record was last updated 13 years ago.
- NPI
- 1720176332
- Provider Name
- DR. BEVERLY ANN DE LA BRUERE
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 18151 SE HIGHWAY 212 DAMASCUS, OR 97089
- Location Phone
- (503) 658-6022
- Location Fax
- (503) 658-7818
- Mailing Address
- 18151 SE HIGHWAY 212 DAMASCUS, OR 97089
- Mailing Phone
- (503) 658-6022
- Mailing Fax
- (503) 658-7818
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-10-2006
- Last Update Date
- 08-02-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Addiction Medicine
- Taxonomy Code
- 207QA0401X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD15031
- License State
- OR
- Taxonomy Description
- A family medicine physician who specializes in the diagnosis and treatment of addictions.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- HSA Qualified 7100 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| C92493 | MEDICARE UPIN (02) | OR | |
| R0000BHXVZ | MEDICARE ID-TYPE UNSPECIFIED (04) | OR | |
| 110403 | MEDICAID (05) | OR |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D0621790
- Facility Type
- Physician Office
- Certificate Effective Date
- January 01, 2024
- Certificate Expiration Date
- December 31, 2025
- Laboratory Director
- BEVERLY A. DE LA BRUERE MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Beverly De La Bruere in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 2 | 0 | 1 | 7 | 6 | 3 | 3 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 4 | 0 | 2 | 7 | 12 | 3 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 4 + 0 + 2 + 7 + 1 + 2 + 3 + 6 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1720176332 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1407205313 | HEALTHY CHOICES WELLNESS CENTER INC Organization | Clinic/Center (Primary Care) | 18151 SE HIGHWAY 212 DAMASCUS, OR 97089 (503) 658-6022 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720176332, enumerated in the NPI registry as an "individual" on October 10, 2006
The provider is located at 18151 Se Highway 212 Damascus, Or 97089 and the phone number is (503) 658-6022
The provider's speciality is Family Medicine with taxonomy code 207QA0401X with a focus in Addiction Medicine
The provider might be accepting Accepts: Providence Health Plan, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 38D0621790 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on October 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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