Individual provider Active NPI

Ralph Peter Rubeo, OPTICIAN

  • Optician
  • Wilmington, DE
National Provider Identifier
1063687002
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
44006 Issued in DE
Practice address
811 N Market St
Wilmington, DE 19801
Phone
(302) 654-1466
Fax
(302) 654-1470
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 44006 DE Primary

Addresses

Primary practice location

811 N Market St
Wilmington, DE 19801

Mailing address

811 N Market St
Wilmington, DE 19801-3053
Phone (302) 654-1466

Other identifiers 1

IdentifierTypeStateIssuer
0000883622MedicaidDE

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

State licenses

LicenseStateTypeSpecialty
44006DEMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1063687002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N MARKET ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198013053",
            "telephone_number": "302-654-1466",
            "fax_number": "302-654-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N MARKET ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19801",
            "telephone_number": "302-654-1466",
            "fax_number": "302-654-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBEO",
        "first_name": "RALPH",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "DE",
            "license": "44006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000883622",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.