MARK THOMAS BRULTE (MD) – Internal Medicine Physician, NPI 1205931672

MARK THOMAS BRULTE (MD) is a healthcare provider. based in Douglas, Georgia. specializing in INTERNAL MEDICINE, EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 048490 (GA). The NPI Number for MARK THOMAS BRULTE (MD) is 1205931672

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
MARK THOMAS BRULTE (MD)
NPI
1205931672
Phone
(912) 384-3338
Address
200 DOCTORS DR
Enumeration Date
13 September 2006
Last Update Date
8 December 2010

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Secondary Phone
9123835641
Graduation Year
1993 (33 years ago)
PAC ID
8426055096
Group Practice PAC ID
4880834050
Professional Enrollment ID
I20061025000267
Address ID
GA315332262DO1101XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

5,405 INTERNAL MEDICINE in GA

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Provider Addresses for MARK THOMAS BRULTE (MD)

  • Doctors Drive, Douglas, Coffee County, Georgia, 31534, United States

    SUITE 106

    DOUGLAS, GA 315332201

    Phone: (912) 384-3338

    Fax: (912) 389-0979

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $158.

Total Amount is formed as General ($158) + Research ($0) + Ownership ($0) = $158.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Amgen Inc. ($126).

Total Amount

$158

General + Research + Ownership

Payments

3

Total payment records

General Amount

$158

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Amgen Inc.$126
ABIOMED$32
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-10-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20061025000267IInternal MedicineGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making158149$0
99285Emergency department visit with high level of medical decision making3939$0
99283Emergency department visit with low level of medical decision making3231$0
99291Critical care, first 30-74 minutes2726$0
View full utilization report →

Insurance plans in this area (ZIP 31533)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880834050View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerGA
Family Practice, Emergency MedicineGA
Nurse PractitionerGA
General SurgeryGA
-SC
Internal MedicineGA

Reviews

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Frequently asked questions

How do payers reference MARK THOMAS BRULTE (MD)?
For MARK THOMAS BRULTE (MD), use NPI 1205931672 as the unique 10-digit identifier.
Is MARK THOMAS BRULTE (MD) still an active registrant?
MARK THOMAS BRULTE (MD) carries an active NPI according to the public dataset.
What area of care is associated with MARK THOMAS BRULTE (MD)?
MARK THOMAS BRULTE (MD)'s record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Georgia is MARK THOMAS BRULTE (MD) registered?
Use Douglas, Georgia as the headline location for MARK THOMAS BRULTE (MD) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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