Individual provider Active NPI

Mark Alan Rabin, DPM

  • Podiatrist
  • Philadelphia, PA
National Provider Identifier
1457332405
Registry record updated Dec 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC001354L Issued in PA
Practice address
2375 Woodward St
Suite 111N
Philadelphia, PA 19115-5120
Phone
(215) 676-7080
Fax
(215) 676-7802
NPI assigned
Nov 8, 2005
Last updated
Dec 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC001354L PA Primary

Addresses

Primary practice location

2375 Woodward St
Suite 111N
Philadelphia, PA 19115-5120

Mailing address

2375 Woodward St
Suite 111N
Philadelphia, PA 19115-5120
Phone (215) 676-7080

Other identifiers 1

IdentifierTypeStateIssuer
0005067180001MedicaidPA

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

State licenses

LicenseStateTypeSpecialty
SC001354LPAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark a. Rabin DPM Associates Podiatrist PastSince May 17, 2002 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198540800000",
    "number": "1457332405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 WOODWARD ST",
            "address_2": "SUITE 111N",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191155120",
            "telephone_number": "215-676-7080",
            "fax_number": "215-676-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 WOODWARD ST",
            "address_2": "SUITE 111N",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191155120",
            "telephone_number": "215-676-7080",
            "fax_number": "215-676-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABIN",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2007-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC001354L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005067180001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 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.