Individual provider Active NPI

Jill M Rubin, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1114209624
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10491 Issued in FL
Practice address
915 Middle River Dr Ste 410
Fort Lauderdale, FL 33304-3561
Phone
(954) 263-2929
Fax
(954) 565-6178
NPI assigned
Sep 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW10491 FL Primary

Addresses

Primary practice location

915 Middle River Dr Ste 410
Fort Lauderdale, FL 33304-3561

Mailing address

915 Middle River Dr Ste 410
Fort Lauderdale, FL 33304-3561
Phone (954) 263-2929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121012000137 FL Practitioner - Clinical Social Worker 3476702184 Practice locations: Fort Lauderdale, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

915 Middle River Dr
Suite 417
Fort Lauderdale, FL 33304-3561
Phone (954) 263-2929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jill M Rubin LCSW Clinical CurrentSince Sep 12, 2011 Accepting new patients
Faith S Sperry Psy D PA Past Accepting new patients

Locations

915 Middle River Dr
Ste 417
Fort Lauderdale, FL 33304
Phone (954) 263-2929

Organizations & group practices 2

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": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1114209624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR STE 410",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043561",
            "telephone_number": "954-263-2929",
            "fax_number": "954-565-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR STE 410",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043561",
            "telephone_number": "954-263-2929",
            "fax_number": "954-565-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.