Individual provider Active NPI

Caroline Rubin

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1124559596
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95005369 Issued in CA
Practice address
568 E Herndon Ave Ste 201
Fresno, CA 93720-2989
Phone
(619) 203-9452
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95005369 CA Primary

Addresses

Primary practice location

568 E Herndon Ave Ste 201
Fresno, CA 93720-2989

Mailing address

568 E Herndon Ave Ste 201
Fresno, CA 93720-2989
Phone (619) 203-9452

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231109002300 CA Practitioner - Nurse Practitioner 0143677351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as group
Quality
43.03
Promoting interoperability
0
Improvement activities
40
Cost
72.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nephrology Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Plastic Surgery Partners of Fresno CurrentSince Oct 28, 2024 Accepting new patients
The Nephrology Group, Inc. Clinical Lab CurrentSince Oct 1, 2023 Accepting new patients
Ucsd Heath Care Past Accepting new patients

Locations

568 E Herndon Ave
Ste 201
Fresno, CA 93720
Phone (559) 228-9660

215 N Fresno St
Ste 490
Fresno, CA 93701
Phone (559) 459-4101

Organizations & group practices 4

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1124559596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 E HERNDON AVE STE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202989",
            "telephone_number": "619-203-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 E HERNDON AVE STE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202989",
            "telephone_number": "619-203-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "CAROLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.