Individual provider Active NPI

Jeffrey M. Rubin, ED.D.

  • Clinical Psychologist
  • Newburgh, NY
National Provider Identifier
1164596276
Registry record updated Jul 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009625 Issued in NY
Practice address
320 Robinson Ave
Ste 201-a
Newburgh, NY 12550-3353
Phone
(845) 564-2540
Fax
(845) 564-2544
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 009625 NY Primary

Addresses

Primary practice location

320 Robinson Ave
Ste 201-a
Newburgh, NY 12550-3353

Mailing address

320 Robinson Ave
Ste 201-a
Newburgh, NY 12550-3353
Phone (845) 564-2540

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
I20041028001124 NY Practitioner - Clinical Psychologist 1052373321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Columbia University College of Physicians and Surgeons, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rubin Psychological Services PCGroup PAC ID 6709967904, 3 clinicians

Practice addresses (Care Compare)

320 Robinson Ave
Newburgh, NY 12550-3353
Phone (845) 564-2540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009625NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rubin Psychological Services ,P.C. Clinical CurrentSince Aug 1, 2004 Accepting new patients

Locations

320 Robinson Ave
Ste 201A
Newburgh, NY 12550
Phone (845) 564-2540

450 Gidney Ave
Ste 201
Newburgh, NY 12550
Phone (845) 564-2540

Organizations & group practices 1

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1164596276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ROBINSON AVE",
            "address_2": "STE 201-A",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503353",
            "telephone_number": "845-564-2540",
            "fax_number": "845-564-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ROBINSON AVE",
            "address_2": "STE 201-A",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503353",
            "telephone_number": "845-564-2540",
            "fax_number": "845-564-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JEFFREY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.