Individual provider Active NPI

Marie G. Lubin, PA

  • Internal Medicine Physician
  • New Hyde Park, NY
National Provider Identifier
1063532083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
008435 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1433
Phone
(718) 470-7000
NPI assigned
Mar 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 008435 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1433

Mailing address

972 Brush Hollow Rd
Westbury, NY 11590-1740
Phone (516) 876-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000400 NY Practitioner - Physician Assistant 6507033172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063532083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-5555",
            "fax_number": "516-876-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401433",
            "telephone_number": "718-470-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBIN",
        "first_name": "MARIE",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "008435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.