Individual provider Active NPI

Gabriel V Rubanenko, M.D.

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1194704643
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A39466 Issued in CA
Practice address
6200 Wilshire Blvd
Suite 910
Los Angeles, CA 90048-5801
Phone
(323) 965-5088
Fax
(310) 274-1040
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A39466 CA Primary

Addresses

Primary practice location

6200 Wilshire Blvd
Suite 910
Los Angeles, CA 90048-5801

Mailing address

6200 Wilshire Blvd
Suite 908
Los Angeles, CA 90048-5801
Phone (323) 965-5088

Other identifiers 1

IdentifierTypeStateIssuer
00A394660MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070628000539 CA Practitioner - Orthopedic Surgery 2961501127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6200 Wilshire Blvd
Suite 908
Los Angeles, CA 90048-5810
Phone (323) 965-5088

Hospital & facility affiliations

  • Helping Hands Home Health Best Care, Inc Home health agency, Van Nuys, CA, CCN 559792
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A39466CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Rubanenko Inc a Medical Corporation Orthopaedic Surgery CurrentSince Feb 1, 2007 Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Gabriel Rubanenko, Inc., a Medical Corporation Past Accepting new patients
Gabriel Rubanenko, M.D. Inc Orthopaedic Surgery Past Accepting new patients

Locations

6200 Wilshire Blvd
Ste 910
Los Angeles, CA 90048
Phone (323) 933-3434

6200 Wilshire Blvd
Ste 908
Los Angeles, CA 90048
Phone (323) 655-3933

15165 Ventura Blvd
Ste 300330
Sherman Oaks, CA 91403

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1194704643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 908",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-965-5088",
            "fax_number": "310-274-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 910",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-965-5088",
            "fax_number": "310-274-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBANENKO",
        "first_name": "GABRIEL",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A39466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A394660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.