Organization Active NPI

J. Nathan Rubin, M.D., F.a.C.C., Inc.

  • Cardiovascular Disease Physician
  • Sherman Oaks, CA
National Provider Identifier
1336262906
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G53079 Issued in CA
Legal business name
J. NATHAN RUBIN, M.D., F.A.C.C., INC.
Practice address
4940 Van Nuys Blvd
Suite 200
Sherman Oaks, CA 91403-1741
Phone
(818) 501-1455
Fax
(818) 528-1013
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Dr. J. Nathan Rubin, M.D.
Title
Medical Doctor
Phone
(818) 501-1455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X G53079 CA Primary

Addresses

Primary practice location

4940 Van Nuys Blvd
Suite 200
Sherman Oaks, CA 91403-1741

Mailing address

4940 Van Nuys Blvd
Suite 200
Sherman Oaks, CA 91403-1741
Phone (818) 501-1455

Other identifiers 1

IdentifierTypeStateIssuer
00G530790MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070730000590 CA Part B Supplier - Clinic/Group Practice 9133220536 Receives reassigned benefits from 1 practitioner
Practice locations: Encino, CA; Sherman Oaks, CA; Van Nuys, CA

National Provider Directory

National Provider Directory
Tax ID family
J Nathan Rubin MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2787/brand/1/csg/1/fhir/r4

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": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1336262906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD",
            "address_2": "SUITE 200",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031741",
            "telephone_number": "818-501-1455",
            "fax_number": "818-528-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD",
            "address_2": "SUITE 200",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031741",
            "telephone_number": "818-501-1455",
            "fax_number": "818-528-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. NATHAN RUBIN, M.D., F.A.C.C., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "818-501-1455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G53079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G530790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.