Mark G. Rubin, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

G54534 Issued in CA

Practice address

153 S Lasky Dr
Suite 1
Beverly Hills, CA 90212-1721

Phone

(310) 556-0119

Fax

(310) 556-0111

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 20, 2016 through Jan 20, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Authorized official Same address or phone
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  • Dermatology Physician
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  • NPI 1740469725

  Specialist

  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356453666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 S LASKY DR",
            "address_2": "SUITE 1",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121721",
            "telephone_number": "310-556-0119",
            "fax_number": "310-556-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 S LASKY DR",
            "address_2": "SUITE 1",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121721",
            "telephone_number": "310-556-0119",
            "fax_number": "310-556-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "MARK",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G54534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Rozenblat, FNP-BC
• RPH Surgery Center Corp
• RPT Physical Therapy, Inc
• RS Venuturupalli MD Inc
• Irwin Ruben, M.D.
• Mark J Rubin, MD
• Paige Rubin
• Steven B Rubins, M.D.
• Robert Owen Ruder, MD
• Jonathan David Rudner, D.D.S.

• Specialist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.