Organization Active NPI

Edward S. Rubin, MD PC

  • Interventional Pain Medicine Physician
  • New Hyde Park, NY
National Provider Identifier
1225200835
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
235004 Issued in NY
Legal business name
EDWARD S. RUBIN, MD PC
Practice address
410 Lakeville Rd Ste 303
New Hyde Park, NY 11042-1104
Phone
(516) 359-7246
Fax
(516) 403-1887
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Authorized official

Name
Dr. Edward S Rubin, MDNPI 1174563431
Title
Owner/President
Phone
(516) 492-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 235004 NY Primary

Addresses

Primary practice location

410 Lakeville Rd Ste 303
New Hyde Park, NY 11042-1104

Mailing address

410 Lakeville Rd Ste 303
New Hyde Park, NY 11042-1104
Phone (516) 359-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080811000461 NY Part B Supplier - Clinic/Group Practice 9032283981 Receives reassigned benefits from 1 practitioner
Practice locations: New Hyde Park, NY

National Provider Directory

National Provider Directory

Locations

1103 Stewart Ave
Fl 3
Garden City, NY 11530
Phone (516) 248-3737

410 Lakeville Rd
Ste 303
New Hyde Park, NY 11042
Phone (516) 321-7555

57 Ira Rd
#207
Syosset, NY 11791

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1225200835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD STE 303",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421104",
            "telephone_number": "516-359-7246",
            "fax_number": "516-403-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD STE 303",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421104",
            "telephone_number": "516-359-7246",
            "fax_number": "516-403-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD S. RUBIN, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "516-492-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "235004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.