NPIMap

Organization Active NPI

Rubis Plastic Surgery, PLLC

  • Plastic and Reconstructive Surgery Physician
  • Tulsa, OK
National Provider Identifier
1013071166
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
21510 Issued in OK
Legal business name
RUBIS PLASTIC SURGERY, PLLC
Practice address
10119 E 80TH St
Suite a
Tulsa, OK 74133-3407
Phone
(918) 254-6793
Fax
(918) 254-6796
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brent A. Rubis, MD
Title
Owner
Phone
(918) 254-6793

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X 21510 OK
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X 21510 OK Primary

Addresses

Primary practice location

10119 E 80TH St
Suite a
Tulsa, OK 74133-3407

Mailing address

10119-A East 80TH Street South
Tulsa, OK 74133
Phone (918) 254-6793

Other identifiers 1

IdentifierTypeStateIssuer
100749040AMedicaidOK

National Provider Directory

National Provider Directory

Locations

10119 E 80th St
Ste A
Tulsa, OK 74133
Phone (918) 254-6793

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1013071166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10119-A EAST 80TH STREET SOUTH",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "918-254-6793",
            "fax_number": "918-254-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10119 E 80TH ST",
            "address_2": "SUITE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741333407",
            "telephone_number": "918-254-6793",
            "fax_number": "918-254-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBIS PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "RUBIS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-254-6793",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "OK",
            "license": "21510",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "OK",
            "license": "21510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100749040A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.