Active NPI
Tigerlily Lee Rubin, MD
- Pediatrics Physician
- Broomall, PA
National Provider Identifier
1114949690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD-065239-L
- Practice address
- 2000 Sproul Rd
Suite 206
Broomall, PA 19008 - Phone
- (610) 284-0200
- Fax
- (610) 353-7932
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD-065239-L | PA | Primary |
Addresses
Primary practice location
2000 Sproul Rd
Suite 206
Broomall, PA 19008
Mailing address
2000 Sproul Rd
Suite 206
Broomall, PA 19008
Phone (610) 284-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001954678 | Medicaid | PA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-065239-L | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421280000000",
"number": "1114949690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 SPROUL RD",
"address_2": "SUITE 206",
"city": "BROOMALL",
"state": "PA",
"postal_code": "19008",
"telephone_number": "610-284-0200",
"fax_number": "610-353-7932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 SPROUL RD",
"address_2": "SUITE 206",
"city": "BROOMALL",
"state": "PA",
"postal_code": "19008",
"telephone_number": "610-284-0200",
"fax_number": "610-353-7932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBIN",
"first_name": "TIGERLILY LEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2015-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD-065239-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001954678",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broomall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.