Individual provider Active NPI

Paul J Rubis, MD

  • Specialist
  • Richmond, VA
National Provider Identifier
1619900529
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101033427 Issued in VA
Practice address
11525 Midlothian Tpke
Suite 103 & 104
Richmond, VA 23235-4763
Phone
(804) 594-2550
Fax
(804) 594-3950
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101033427 VA Primary
Specialist 174400000X 31376 NC
Specialist 174400000X 040530 GA
Specialist 174400000X 20090 SC

Addresses

Primary practice location

11525 Midlothian Tpke
Suite 103 & 104
Richmond, VA 23235-4763

Mailing address

PO Box 860
5220 Claytonshire Court
Glen Allen, VA 23060-0860
Phone (804) 346-4246

Other identifiers 1

IdentifierTypeStateIssuer
7207891MedicaidVA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31376NCMDAddiction (Substance Use Disorder) Counselor
040530GAMDSpecialist
20090SCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Open MRI of Southern VA Past Accepting new patients
Richmond West End Diagnostic Imaging, LLC PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 2

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619900529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860",
            "address_2": "5220 CLAYTONSHIRE COURT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230600860",
            "telephone_number": "804-346-4246",
            "fax_number": "804-747-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 MIDLOTHIAN TPKE",
            "address_2": "SUITE 103 & 104",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354763",
            "telephone_number": "804-594-2550",
            "fax_number": "804-594-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIS",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101033427",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "31376",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "040530",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "20090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7207891",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.