Individual provider Active NPI

Richard I Rubin, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1225210693
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2006-0014 Issued in NM
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

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PA13273CAMDPhysician Assistant
PA2006-0014NMMDPhysician Assistant
PA2009-0014NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.