Individual provider Active NPI

Audrey P Rubano, NP

  • Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1528123775
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024173352 Issued in VA
Practice address
8100 Ashton Ave
Manassas, VA 20109-5622
Phone
(703) 361-3255
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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 0024173352 VA Primary

Addresses

Primary practice location

8100 Ashton Ave
Manassas, VA 20109-5622

Mailing address

3689 Waples Crest CT
Oakton, VA 22124-2134
Phone (917) 328-2850

Other practice location 1

2848 S Delsea Dr
Building 2C
Vineland, NJ 08360-7042
Phone (856) 794-9090

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024173352VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
On-Site Specialty Care, LLC Nurse Practitioner Past Accepting new patients
Primary Homecare, LLC Gerontology Past Accepting new patients
Arthiritis and Osteoporosis Northern Virginia Inc PastSince Nov 1, 2004 Accepting new patients
Infusion Services of South Jersey LLC PastSince Nov 13, 2022 Accepting new patients

Organizations & group practices 4

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1528123775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3689 WAPLES CREST CT",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221242134",
            "telephone_number": "917-328-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095622",
            "telephone_number": "703-361-3255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2848 S Delsea Dr",
            "address_2": "Building 2C",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083607042",
            "country_code": "US",
            "telephone_number": "856-794-9090",
            "fax_number": "856-794-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBANO",
        "first_name": "AUDREY",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024173352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.