Individual provider Active NPI

Jeffrey Scott Rubin, LCSWC

  • Clinical Social Worker
  • Sykesville, MD
National Provider Identifier
1235228057
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07099 Issued in MD
Practice address
5420 Klee Mill Rd S
Suite 6
Sykesville, MD 21784-9230
Phone
(410) 552-6633
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 07099 MD Primary

Addresses

Primary practice location

5420 Klee Mill Rd S
Suite 6
Sykesville, MD 21784-9230

Mailing address

5420 Klee Mill Rd S
Suite 6
Sykesville, MD 21784-9230
Phone (410) 552-6633

Other identifiers 1

IdentifierTypeStateIssuer
52497404OtherMDCAREFIRST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080219000813 MD Practitioner - Clinical Social Worker 2163506882 Practice locations: Sykesville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5420 Klee Mill Rd
Suite 6
Sykesville, MD 21784-9230

5420 Klee Mill Rd S
Suite 6
Sykesville, MD 21784-9230
Phone (410) 552-6633

5420 Klee Mill S Rd
Suite 6
Sykesville, MD 21784-9230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07099MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1235228057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 KLEE MILL RD S",
            "address_2": "SUITE 6",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217849230",
            "telephone_number": "410-552-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 KLEE MILL RD S",
            "address_2": "SUITE 6",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217849230",
            "telephone_number": "410-552-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LCSWC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "52497404",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sykesville, MD

Sources for this page

Verify at the official NPI Registry.