Individual provider Active NPI

Jeffrey H Lubin, MD

  • Emergency Medicine Physician
  • Destin, FL
National Provider Identifier
1457303703
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD026079E Issued in PA
Practice address
10 Harbor Blvd
#927
Destin, FL 32541-7374
Phone
(570) 760-6939
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD026079E PA Primary

Addresses

Primary practice location

10 Harbor Blvd
#927
Destin, FL 32541-7374

Mailing address

23811 Canella CT
#927
Richmond, TX 77406-1522
Phone (775) 247-2733

Other identifiers 1

IdentifierTypeStateIssuer
001033178MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD026079EPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Current Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients
On Demand Urgent Care Group PC PastSince Feb 1, 2017 Accepting new patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Mercy Tyler Hospital Past Accepting new patients
Mercy Tyler Health Systems Past Accepting new patients

Locations

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

Organizations & group practices 6

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1457303703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23811 CANELLA CT",
            "address_2": "#927",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061522",
            "telephone_number": "775-247-2733",
            "fax_number": "281-783-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HARBOR BLVD",
            "address_2": "#927",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325417374",
            "telephone_number": "570-760-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBIN",
        "first_name": "JEFFREY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD026079E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001033178",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.