Individual provider Active NPI

Michael E Rubio, PA-C

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1568967727
Registry record updated Mar 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
021899 Issued in NY
Practice address
607 Halsey St Apt 2
Brooklyn, NY 11233-1201
Phone
(646) 493-9548
Fax
(646) 222-8784
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 021899 NY Primary

Addresses

Primary practice location

607 Halsey St Apt 2
Brooklyn, NY 11233-1201

Mailing address

607 Halsey St Apt 2
Brooklyn, NY 11233-1201
Phone (646) 493-9548

Other identifiers 1

IdentifierTypeStateIssuer
0554076MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190410001282 NY Practitioner - Physician Assistant 5799026274 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021899NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bobby Buka, M.D., P.C. CurrentSince Feb 25, 2019 Accepting new patients
Rubio Physician Assistant PC Medical CurrentSince Feb 8, 2023 Accepting new patients
Derm Specs of PA PLLC PastSince Feb 25, 2024 Accepting new patients

Locations

1027 46th Ave
Fl 1
Long Island City, NY 11101

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679702400000",
    "number": "1568967727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 HALSEY ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112331201",
            "telephone_number": "646-493-9548",
            "fax_number": "646-222-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 HALSEY ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112331201",
            "telephone_number": "646-493-9548",
            "fax_number": "646-222-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "021899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0554076",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.