Active NPI
Peter H Rubin MD PC
- Gastroenterology Physician
- New York, NY
National Provider Identifier
1104163526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- PETER H RUBIN MD PC
- Practice address
- 920 Park Ave
New York, NY 10028-0208 - Phone
- (212) 535-3400
- NPI assigned
- Jan 4, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Elizabeth Sweeney
- Title
- Billing Manager
- Phone
- (212) 535-3400
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
920 Park Ave
New York, NY 10028-0208
Mailing address
920 Park Ave
New York, NY 10028-0208
Phone (212) 535-3400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180111000075 | NY | Part B Supplier - Clinic/Group Practice | 9335385590 | Practice locations: New York, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0941357 | Peter H Rubin, MD, PC | Certificate of waiver | Jul 6, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357257600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1357257600000",
"number": "1104163526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 PARK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100280208",
"telephone_number": "212-535-3400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 PARK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100280208",
"telephone_number": "212-535-3400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PETER H RUBIN MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2013-01-04",
"last_updated": "2013-01-04",
"status": "A",
"authorized_official_last_name": "SWEENEY",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "212-535-3400",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.