Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Marie Lynne Deruyter, MD

Individual provider Pain Medicine (Anesthesiology) Physician · NPI 1164419453

Dr. Marie Lynne Deruyter, MD is an Anesthesiology in Jacksonville, Florida. Graduated from Creighton University School of Medicine in 1994, 32 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
32
Trained at
Creighton University School of Medicine
Licensed in
FL
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence ME62548 (FL)
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X · Licence ME62548 (FL)

Record details

NPI number1164419453
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 1, 2005
Last updated in NPPESSeptember 2, 2020
Certification dateSeptember 2, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolCREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1994 (32 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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