Organization Active NPI

Rubin Psychological Services ,P.C.

  • Clinical Psychologist
  • Newburgh, NY
National Provider Identifier
1568505162
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009625 Issued in NY
Legal business name
RUBIN PSYCHOLOGICAL SERVICES ,P.C.
Practice address
450 Gidney Ave
Suite 201
Newburgh, NY 12550-3116
Phone
(845) 654-2540
Fax
(845) 564-2544
NPI assigned
Feb 14, 2007
Last updated
Nov 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Authorized official

Name
Dr. Jeffrey M. Rubin, ED.D.NPI 1164596276
Title
President
Phone
(845) 564-2540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 009625 NY Primary

Addresses

Primary practice location

450 Gidney Ave
Suite 201
Newburgh, NY 12550-3116

Mailing address

450 Gidney Ave
Suite 201
Newburgh, NY 12550-3116
Phone (845) 654-2540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080114000550 NY Part B Supplier - Clinic/Group Practice 6709967904 Receives reassigned benefits from 3 practitioners
Practice locations: Newburgh, NY

National Provider Directory

National Provider Directory

Locations

320 Robinson Ave
Ste 201A
Newburgh, NY 12550
Phone (845) 564-2540

450 Gidney Ave
Ste 201
Newburgh, NY 12550
Phone (845) 564-2540

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1568505162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 GIDNEY AVE",
            "address_2": "SUITE 201",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503116",
            "telephone_number": "845-654-2540",
            "fax_number": "845-564-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 GIDNEY AVE",
            "address_2": "SUITE 201",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503116",
            "telephone_number": "845-654-2540",
            "fax_number": "845-564-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBIN PSYCHOLOGICAL SERVICES ,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-564-2540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.