Benjamin A Dubin, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

103 S Greenleaf St
Suite J
Gurnee, IL 60031-3380

Phone

(847) 662-8201

Fax

(847) 662-8215

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of Lagrange SCGroup PAC ID 7113830951, 19 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.78 of 100Reported as group

Quality

87.26

Promoting interoperability

100

Improvement activities

40

Cost

58.68

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdubin@directaddress.net

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.

• Dermatology Associates of Lagrange SC

  • Dermatology Physician
  • La Grange Highlands, IL
  • NPI 1780795856
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1356495030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S GREENLEAF ST",
            "address_2": "SUITE J",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313380",
            "telephone_number": "847-662-8201",
            "fax_number": "847-662-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S GREENLEAF ST",
            "address_2": "SUITE J",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313380",
            "telephone_number": "847-662-8201",
            "fax_number": "847-662-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBIN",
        "first_name": "BENJAMIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360399611",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP NUMBER",
            "identifier": "453550",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI PRACTICE NUMBER",
            "identifier": "1609827237",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDR INDIVIDUAL NUMBER",
            "identifier": "K39550",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "4920144",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4392571",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "7248829002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr. Cooper2 Gentle Dental Assoc., LTD.
• Dr. Eric Nicholls and Associates, P.C.
• Dr. Ogufere DDS, P.C
• DRS. Gandolfi & Swafford L.L.C.
• DS Medical Support LLC
• Sonia Dubose, MSW, LCSW, CADC
• Abigail Irene Dudek
• Robert Dugan, MD
• Alisa Marie Dulak, PT
• Steve Dulak, M.P.T.

• Specialist in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.