NPIMap

Individual provider Active NPI

Jack E Rubin, M.D.

  • Nephrology Physician
  • Inglewood, CA
National Provider Identifier
1346236205
Registry record updated May 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G060194 Issued in CA
Practice address
575 E Hardy St
Suite 322
Inglewood, CA 90301-4036
Phone
(310) 671-0488
Fax
(310) 671-7618
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G060194 CA Primary

Addresses

Primary practice location

575 E Hardy St
Suite 322
Inglewood, CA 90301-4036

Mailing address

PO Box 260458
Encino, CA 91426-0458
Phone (818) 784-4201

Other identifiers 1

IdentifierTypeStateIssuer
00G60194MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051007000804 CA Practitioner - NephrologyPractitioner - Internal Medicine 6709801848 Reassigns benefits to 1 organization
Practice locations: Inglewood, CA

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10727 White Oak Ave
Suite 117
Granada Hills, CA 91344-4600
Phone (818) 593-9140

Hospital & facility affiliations

  • DaVita Los Angeles Dialysis Center Dialysis facility, Los Angeles, CA, CCN 052695
  • DaVita Airport Sunrise Dialysis Center Dialysis facility, Inglewood, CA, CCN 052746
  • Liverpool Home Care Services Home health agency, Pasadena, CA, CCN 559724
  • H & M Home Health Care, Inc Home health agency, Pasadena, CA, CCN 559300
  • Havana Home Health, Inc Home health agency, Mission Hills, CA, CCN 757541
  • Always There Home Health Inc Home health agency, Winnetka, CA, CCN 758194
  • Easi Home Health Care, Inc Home health agency, Mission Hills, CA, CCN 559144
  • Pristine Care Hospice Corp. Hospice, Burbank, CA, CCN D61532
  • A Touch of Angel Hospice Inc Hospice, Glendale, CA, CCN B51710
  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G060194CAMDNephrology Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Bernard Salick Nephrology Past Accepting new patients
Canon Medical Group Inc Nephrology Past Accepting new patients
Los Angeles Peripheral Arterial Disease Center Medical Group PastSince Apr 16, 2012 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
A Touch of Angel Hospice IncGlendale, CA, CCN B51710 Hospice W-2 Managing Employee Apr 1, 2025
TH Caring Hospice Care IncVan Nuys, CA, CCN B51706 Hospice Contracted Managing Employee Mar 1, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209772800000",
    "number": "1346236205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260458",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914260458",
            "telephone_number": "818-784-4201",
            "fax_number": "818-784-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST",
            "address_2": "SUITE 322",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014036",
            "telephone_number": "310-671-0488",
            "fax_number": "310-671-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JACK",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2008-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G060194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G60194",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.