Active NPI
Bruce Kalman Rubin, MD, MENGR, MBA
- Pediatric Pulmonology Physician
- Richmond, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 0101246124
- Practice address
- 1000 E Broad St
Richmond, VA 23219-1930 - Phone
- (804) 828-2467
- Fax
- (804) 828-9439
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | 9701576 | NC | |
| Pediatric Pulmonology Physician | 2080P0214X | 0101246124 | VA | Primary |
Addresses
Primary practice location
1000 E Broad St
Richmond, VA 23219-1930
Mailing address
PO Box 780125
Philadelphia, PA 19178-0125
Phone (804) 922-4844
Other practice location 1
1250 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-2467
Other practice location 2
1200 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-2467
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891093T | Medicaid | NC | |
| Q0157C | Medicaid | SC | |
| 6729738 | Medicaid | VA | |
| 7556338 | Other | AETNA | |
| 1093T | Other | BCBS | |
| 17762 | Other | PARTNERS | |
| 76111 | Other | MEDCOST | |
| 220407000 | Medicaid | WV | |
| 370020986 | Other | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Hospitals Medical Group Inc | Current | Accepting new patients | |
| MCV Associated Physicians | Current | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients | |
| University Hospitals Cleveland Medical Center | Past | Accepting new patients |
Locations
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024
11100 Euclid Ave
Fl Hhvi
Cleveland, OH 44106
11100 Euclid Ave
Cleveland Heights, OH 44106
1200 E Marshall St
Richmond, VA 23298
Phone (804) 827-0561
1001 E Marshall St
#980646
Richmond, VA 23298
1001 E Marshall St
Richmond, VA 23298
Phone (804) 828-0099
1000 E Broad St
Richmond, VA 23219
1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990
401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1669499414
-
dba Pacific Sports Medicine @ MultiCare
- Nurse Practitioner
- Tacoma, WA
- NPI 1407808413
-
dba University Hospitals Rainbow Babies & Childrens Hospital
- Children's Hospital
- Cleveland, OH
- NPI 1518042175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718064000000",
"number": "1235113317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 780125",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191780125",
"telephone_number": "804-922-4844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E BROAD ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232191930",
"telephone_number": "804-828-2467",
"fax_number": "804-828-9439"
}
],
"practiceLocations": [
{
"address_1": "1250 E Marshall St",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232985023",
"country_code": "US",
"telephone_number": "804-828-2467",
"fax_number": "804-828-9429",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 E Marshall St",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232985023",
"country_code": "US",
"telephone_number": "804-828-2467",
"fax_number": "804-828-9439",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUBIN",
"first_name": "BRUCE",
"middle_name": "KALMAN",
"credential": "MD, MENGR, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2024-06-11",
"certification_date": "2024-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "NC",
"license": "9701576",
"primary": false
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "VA",
"license": "0101246124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891093T",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q0157C",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6729738",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7556338",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1093T",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "17762",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "76111",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220407000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "370020986",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.