Organization Active NPI

Hortense & Louis Rubin Dialysis Center, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Troy, NY
National Provider Identifier
1386605772
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
4102201R Issued in NY
Legal business name
HORTENSE & LOUIS RUBIN DIALYSIS CENTER, INC.
Practice address
1850 Peoples Ave
Troy, NY 12180-3607
Phone
(518) 271-0702
Fax
(518) 271-0624
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Authorized official

Name
Mr. Wayne A Evancoe, CEO
Title
Administrator
Phone
(518) 271-0702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 4102201R NY Primary

Addresses

Primary practice location

1850 Peoples Ave
Troy, NY 12180-3607

Mailing address

1850 Peoples Ave
Troy, NY 12180-3607
Phone (518) 271-0702

Other identifiers 5

IdentifierTypeStateIssuer
953252OtherNYMVP
000400438001OtherNYBSNENY
00964250MedicaidNY
10005842OtherNYCDPHP
005376OtherNYEBCBS

National Provider Directory

National Provider Directory

Locations

21 Crossing Blvd
Halfmoon, NY 12065
Phone (518) 831-6700

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1386605772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 PEOPLES AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121803607",
            "telephone_number": "518-271-0702",
            "fax_number": "518-271-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 PEOPLES AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121803607",
            "telephone_number": "518-271-0702",
            "fax_number": "518-271-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORTENSE & LOUIS RUBIN DIALYSIS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "EVANCOE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "518-271-0702",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "4102201R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "953252",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY",
            "identifier": "000400438001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00964250",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10005842",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EBCBS",
            "identifier": "005376",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.