Individual provider Active NPI

Eileen Rubin, LCSW

  • Clinical Social Worker
  • Port Washington, NY
National Provider Identifier
1124206826
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071296 Issued in NY
Practice address
75 W Shore Rd Unit 18
Port Washington, NY 11050-3007
Phone
(516) 606-0368
NPI assigned
Feb 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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 071296 NY Primary

Addresses

Primary practice location

75 W Shore Rd Unit 18
Port Washington, NY 11050-3007

Mailing address

75 W Shore Rd Unit 18
Port Washington, NY 11050-3007
Phone (516) 606-0368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170328002049 NY Practitioner - Clinical Social Worker 0749565075 Practice locations: Port Washington, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

75 W Shore Rd
Unit 18
Port Washington, NY 11050-3007
Phone (516) 606-0368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1124206826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W SHORE RD UNIT 18",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503007",
            "telephone_number": "516-606-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W SHORE RD UNIT 18",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503007",
            "telephone_number": "516-606-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "EILEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.