NPIMap

Individual provider Active NPI

Gennaro Rubino, M.D.

  • Internal Medicine Physician
  • Clifton, NJ
National Provider Identifier
1194747725
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06284000 Issued in NJ
Practice address
1195 Clifton Ave
Clifton, NJ 07013-3621
Phone
(973) 471-4004
Fax
(973) 471-1180
NPI assigned
Jul 24, 2006
Last updated
May 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA06284000 NJ Primary

Addresses

Primary practice location

1195 Clifton Ave
Clifton, NJ 07013-3621

Mailing address

1195 Clifton Ave
Clifton, NJ 07013-3621
Phone (973) 471-4004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040413000323 NJ Practitioner - Internal Medicine 8123012101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06284000NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
St. Joseph's Healthcare, Inc. Internal Medicine CurrentSince Jan 15, 2018 Accepting new patients
Cepp Innovation Sports & Physical Rehab Center Past Accepting new patients

Locations

1135 Broad St
Clifton, NJ 07013
Phone (973) 574-8585

1135 Broad St
Ste 2
Clifton, NJ 07013
Phone (973) 471-3500

1195 Clifton Ave
Clifton, NJ 07013
Phone (201) 265-5700

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1194747725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133621",
            "telephone_number": "973-471-4004",
            "fax_number": "973-471-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133621",
            "telephone_number": "973-471-4004",
            "fax_number": "973-471-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "GENNARO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06284000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.