Individual provider Active NPI

Joelle Rubin

  • Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1518317155
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00605900 Issued in NJ
Practice address
92 2ND St
Hackensack, NJ 07601-2191
Phone
(551) 996-5900
NPI assigned
Jun 14, 2016
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00605900 NJ Primary

Addresses

Primary practice location

92 2ND St
Hackensack, NJ 07601-2191

Mailing address

40 Hillside Ave
Verona, NJ 07044-1410
Phone (201) 349-7949

Other identifiers 1

IdentifierTypeStateIssuer
0543292MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190130001061 NJ Practitioner - Nurse Practitioner 1759628688 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00605900NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cancer Care Associates LLC CurrentSince Dec 12, 2018 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Dec 12, 2018 Accepting new patients

Locations

100 1st St
Ste 301
Hackensack, NJ 07601
Phone (201) 883-0193

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

92 2nd St
Hackensack, NJ 07601
Phone (551) 996-2210

Organizations & group practices 2

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1518317155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HILLSIDE AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441410",
            "telephone_number": "201-349-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 2ND ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012191",
            "telephone_number": "551-996-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JOELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00605900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0543292",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.