Individual provider Active NPI

Keith Harrison Rubin, M.D.

  • Internal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1043674062
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME87797 Issued in FL
Practice address
2100 N Ocean Blvd
Apt 501
Fort Lauderdale, FL 33305-1934
Phone
(917) 913-8511
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME87797 FL Primary

Addresses

Primary practice location

2100 N Ocean Blvd
Apt 501
Fort Lauderdale, FL 33305-1934

Mailing address

2100 N Ocean Blvd
Apt 501
Fort Lauderdale, FL 33305-1934
Phone (917) 913-8511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME87797FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1043674062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N OCEAN BLVD",
            "address_2": "APT 501",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333051934",
            "telephone_number": "917-913-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N OCEAN BLVD",
            "address_2": "APT 501",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333051934",
            "telephone_number": "917-913-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "KEITH",
        "middle_name": "HARRISON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME87797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.