NPIMap

Organization Active NPI

New York University

Doing business as NYU Langone Ambulatory Care Rego Park

  • Orthopaedic Surgery Physician
  • Boynton Beach, FL
National Provider Identifier
1083130967
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NEW YORK UNIVERSITY
Doing business as
NYU Langone Ambulatory Care Rego Park
Practice address
3301 Quantum Blvd
Boynton Beach, FL 33426-8668
Phone
(877) 648-2964
NPI assigned
Aug 22, 2017
Last updated
Sep 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Andrew T Rubin
Title
VP, Clinical Affairs and Amb. Care
Phone
(212) 263-2672

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X NU
Physical Therapist 225100000X NU

Addresses

Primary practice location

3301 Quantum Blvd
Boynton Beach, FL 33426-8668

Mailing address

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Other practice location 1

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Other names 1

  • NYU Langone Ambulatory Care Rego Park Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171104000269 NY DME Supplier - Physician - General Practice 1355232422 Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory
Tax ID family
Dr J Thomas Roland105 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NYU Langone HospitalsNew York, NY, CCN 330214 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone Hospitals Psychiatric UnitNew York, NY, CCN 33S214 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone HospitalsMineola, NY, CCN 33021401 Hospital Operational/Managerial Control Aug 1, 2019
NYU Langone Amb Care CommackGarden City, NY, CCN 337187 Home health agency Operational/Managerial Control Apr 1, 2015

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1083130967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9785 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743319",
            "telephone_number": "718-261-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 QUANTUM BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268668",
            "telephone_number": "877-648-2964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9785 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113743319",
            "country_code": "US",
            "telephone_number": "718-261-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW YORK UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP, CLINICAL AFFAIRS AND AMB. CARE",
        "authorized_official_telephone_number": "212-263-2672"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYU Langone Ambulatory Care Rego Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.