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

Get Directions Reviews

  • 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
C92493MEDICARE UPIN (02)OR 
R0000BHXVZMEDICARE ID-TYPE UNSPECIFIED (04)OR 
110403MEDICAID (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.

Reviews for DR. BEVERLY ANN DE LA BRUERE

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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.
1720176332
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2740271236
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 = 22

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
1407205313HEALTHY 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.