Peter James Rubertone

Primary specialty

Cardiac-Interventional Technology Radiologic TechnologistTaxonomy code 2471C1106X

Practice address

45 Riverview
Port Ewen, NY 12466-5104

Phone

(845) 505-4141

NPI assigned

Jul 4, 2024

Last updated

Jul 8, 2024By 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 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1447096847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RIVERVIEW",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124665104",
            "telephone_number": "845-505-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RIVERVIEW",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124665104",
            "telephone_number": "845-505-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBERTONE",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-04",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "NY",
            "license": "595962",
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471C1106X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Cardiac-Interventional Technology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Port Ewen RX Inc (Port Ewen Pharmacy)
• Racquel Praino, MS, RD
• Barbara Ann Price, RPH
• Gregory Rogers, SPEECH AND LANGUAGE
• Mary Roosa, CCC-SLP
• Cheyanne Tallas Sandy
• Dana Mary Schechter, RPH
• Lori D Schwark, OTR
• Kate Elizabeth Shellhammer
• Megan Beth Sheth, OTR/L

• Radiologic Technologist in Port Ewen, NY
• Providers in Port Ewen, NY by specialty
• Radiologic Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.