Active NPI
Cory J Rubeck
- Speech-Language Pathologist
- Beachwood, OH
National Provider Identifier
1619783545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11844
- Practice address
- 23293 Commerce Park
Beachwood, OH 44122-5808 - Phone
- (216) 292-7170
- NPI assigned
- Dec 5, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 11844 | OH | Primary |
Addresses
Primary practice location
23293 Commerce Park
Beachwood, OH 44122-5808
Mailing address
25118 Bridgeton Dr
Beachwood, OH 44122-1710
Phone (917) 750-8010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11844 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1619783545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25118 BRIDGETON DR",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441221710",
"telephone_number": "917-750-8010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23293 COMMERCE PARK",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225808",
"telephone_number": "216-292-7170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBECK",
"first_name": "CORY",
"middle_name": "J",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-12-05",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "11844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.