Individual provider Active NPI

Jennifer Rubin, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1639577265
Registry record updated Dec 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0180151 Issued in NY
Practice address
1543 E 16TH St
Brooklyn, NY 11230-6707
Phone
(347) 244-3295
NPI assigned
Dec 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0180151 NY Primary

Addresses

Primary practice location

1543 E 16TH St
Brooklyn, NY 11230-6707

Mailing address

1543 E 16TH St
Brooklyn, NY 11230-6707

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
I20150224001372 NY Practitioner - Physician Assistant 4587980230 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0180151NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Jan 8, 2015 Accepting new patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Jan 8, 2015 Accepting new patients

Locations

5601 1st Ave
Brooklyn, NY 11220
Phone (718) 650-0110

1221 E 14th St
Brooklyn, NY 11230
Phone (718) 434-4600

361 Parksville Rd
Parksville, NY 12768
Phone (845) 292-6821

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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": "1418515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418515200000",
    "number": "1639577265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 E 16TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 E 16TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306707",
            "telephone_number": "347-244-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-14",
        "last_updated": "2014-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0180151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.