Individual provider Active NPI

Kelly Rubenstein, R.D.

  • Registered Dietitian
  • San Diego, CA
National Provider Identifier
1366838914
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1012072 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Apr 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1012072 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

2385 S Melrose Dr
Vista, CA 92081-8788
Phone (760) 300-3647

Other practice location 2

19722 MacArthur Blvd
Irvine, CA 92612
Phone (949) 824-5288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190627003431 CA Practitioner - Registered Dietitian Or Nutrition Professional 9436483237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1920
Phone (858) 249-6753

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1012072CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Current Accepting new patients
Regents of the University of California CurrentSince Jun 25, 2022 Accepting new patients
Shine Inside Nutrition LLC Dietitian, Registered Current Accepting new patients
UC Regents CurrentSince Jun 20, 2019 Accepting new patients
UC Regents CurrentSince Jun 20, 2019 Accepting new patients
Regents of the University of California CurrentSince Jun 25, 2022 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

19722 MacArthur Blvd
Irvine, CA 92612
Phone (949) 824-8641

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

4303 La Jolla Village Dr
Ste 2110
San Diego, CA 92122
Phone (858) 657-8857

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1366838914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2385 S Melrose Dr",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920818788",
            "country_code": "US",
            "telephone_number": "760-300-3647",
            "fax_number": "760-483-1316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19722 MacArthur Blvd",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "92612",
            "country_code": "US",
            "telephone_number": "949-824-5288",
            "fax_number": "949-824-2698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBENSTEIN",
        "first_name": "KELLY",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1012072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.