Active NPI
Richard I Rubin, PA-C
- Physician Assistant
- Albuquerque, NM
National Provider Identifier
1225210693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2006-0014
- Practice address
- 2123A Central Ave SE
#121
Albuquerque, NM 87106 - Phone
- (505) 310-3783
- NPI assigned
- Nov 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2006-0014 | NM | Primary |
| Physician Assistant | 363A00000X | PA13273 | CA |
Addresses
Primary practice location
2123A Central Ave SE
#121
Albuquerque, NM 87106
Mailing address
2123 A Central Ave SE
#121
Albuquerque, NM 87106
Phone (505) 310-3783
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA13273 | CA | MD | Physician Assistant |
| PA2006-0014 | NM | MD | Physician Assistant |
| PA2009-0014 | NM | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctor on Call, LLC | Past | Accepting new patients |
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.
-
- Clinic/Center
- Albuquerque, NM
- NPI 1447425491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1225210693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2123 A CENTRAL AVE SE",
"address_2": "#121",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87106",
"telephone_number": "505-310-3783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2123A CENTRAL AVE SE",
"address_2": "#121",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87106",
"telephone_number": "505-310-3783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBIN",
"first_name": "RICHARD",
"middle_name": "I",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-28",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NM",
"license": "PA2006-0014",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA13273",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.