Individual provider Active NPI

Hallie Ariel Rubin, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1528622891
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9325 Issued in GA
Practice address
2150 Peachford Rd Ste Q
Atlanta, GA 30338-6539
Phone
(678) 615-7032
NPI assigned
Apr 23, 2019
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9325 GA Primary
Medical Physician Assistant 363AM0700X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2150 Peachford Rd Ste Q
Atlanta, GA 30338-6539

Mailing address

4546 Barclay Dr
Atlanta, GA 30338-7147
Phone (770) 457-7994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240221002823 GA Practitioner - Physician Assistant 9436593126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Bio Behavioral AssociatesGroup PAC ID 4789062159, 4 clinicians

Practice addresses (Care Compare)

4546 Barclay Dr
Suite B
Atlanta, GA 30338-7146
Phone (770) 457-7994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9325GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Team Mobile Health Care CurrentSince Sep 28, 2025 Accepting new patients
Young Minds Psychiatry, LC PastSince Aug 11, 2019 Accepting new patients

Locations

2150 Peachford Rd
Ste Q
Atlanta, GA 30338
Phone (678) 615-7032

Organizations & group practices 3

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1528622891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4546 BARCLAY DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303387147",
            "telephone_number": "770-457-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PEACHFORD RD STE Q",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386539",
            "telephone_number": "678-615-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "HALLIE",
        "middle_name": "ARIEL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9325",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.