Active NPI
Deborah Brubaker
- Registered Nurse
- Rensselaer, NY
National Provider Identifier
1124652201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 373991-1
- Practice address
- 87 Washington St
Rensselaer, NY 12144-2613 - Phone
- (518) 449-1142
- NPI assigned
- Feb 27, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 373991-1 | NY | Primary |
Addresses
Primary practice location
87 Washington St
Rensselaer, NY 12144-2613
Mailing address
20 Breezedale Dr
Averill Park, NY 12018-9684
Phone (716) 492-2184
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 373991-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1124652201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 BREEZEDALE DR",
"city": "AVERILL PARK",
"state": "NY",
"postal_code": "120189684",
"telephone_number": "716-492-2184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 WASHINGTON ST",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121442613",
"telephone_number": "518-449-1142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUBAKER",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-27",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "373991-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rensselaer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.