Active NPI
Paul E Brubaker, M.D.
- Family Medicine Physician
- Elizabethtown, PA
National Provider Identifier
1457330722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD015333E
- Practice address
- 418 Cloverleaf Rd
Elizabethtown, PA 17022-9320 - Phone
- (717) 653-1467
- Fax
- (717) 653-1001
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD015333E | PA | Primary |
Addresses
Primary practice location
418 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Mailing address
418 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone (717) 653-1467
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 152951 | Other | PA | HIGHMARK BLUE SHIELD |
| 11635 S101 | Other | PA | GEISINGER HEALTH PLAN |
| 4658501 | Other | PA | AETNA NON-HMO |
| 516338 | Other | PA | AETNA HMO |
| 01652402 | Other | PA | CAPITAL BLUE CROSS |
| B40017 | Other | PA | HEALTH ASSURANCE |
| 0006876500001 | Medicaid | PA | |
| P002666 | Other | PA | GATEWAY HEALTH PLAN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190592000000",
"number": "1457330722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "418 CLOVERLEAF RD",
"city": "ELIZABETHTOWN",
"state": "PA",
"postal_code": "170229320",
"telephone_number": "717-653-1467",
"fax_number": "717-653-1001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "418 CLOVERLEAF RD",
"city": "ELIZABETHTOWN",
"state": "PA",
"postal_code": "170229320",
"telephone_number": "717-653-1467",
"fax_number": "717-653-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUBAKER",
"first_name": "PAUL",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2007-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD015333E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "152951",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH PLAN",
"identifier": "11635 S101",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NON-HMO",
"identifier": "4658501",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "516338",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01652402",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ASSURANCE",
"identifier": "B40017",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006876500001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY HEALTH PLAN",
"identifier": "P002666",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.