NPIMap

Individual provider Active NPI

Gabriella Marie Rubino, M.D., M.S.

  • Family Medicine Physician
  • Rockford, MI
National Provider Identifier
1538515648
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301119329 Issued in MI
Practice address
6050 Northland Dr NE Ste 200
Rockford, MI 49341
Phone
(616) 685-8350
Fax
(616) 363-8870
NPI assigned
May 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301119329 MI Primary

Addresses

Primary practice location

6050 Northland Dr NE Ste 200
Rockford, MI 49341

Mailing address

6050 Northland Dr NE Ste 200
Rockford, MI 49341-9257
Phone (616) 685-8350

Other practice location 1

14 Lake St
Oak Park, IL 60302-2606
Phone (708) 383-0113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190726002401 MI Practitioner - Family Practice 5294098026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6050 Northland Dr NE
Suite 200
Rockford, MI 49341-9257
Phone (616) 685-8350

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health/Saint Mary's Medical Group CurrentSince Jul 17, 2019 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 17, 2019 Accepting new patients
Advantage Health Saint Mary's Medical Group Past Accepting new patients
Saint Mary's Health Services Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

6050 Northland Dr NE
Ste 200
Rockford, MI 49341
Phone (616) 685-8350

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1538515648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 NORTHLAND DR NE STE 200",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419257",
            "telephone_number": "616-685-8350",
            "fax_number": "616-363-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 NORTHLAND DR NE STE 200",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "49341",
            "telephone_number": "616-685-8350",
            "fax_number": "616-363-8870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Lake St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022606",
            "country_code": "US",
            "telephone_number": "708-383-0113",
            "fax_number": "773-836-7381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "GABRIELLA",
        "middle_name": "MARIE",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301119329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, MI

Sources for this page

Verify at the official NPI Registry.