Active NPI
Daniel J Rubenstein, MD
- Dermatology Physician
- Peoria, AZ
National Provider Identifier
1649238890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 13098
- Practice address
- 13943 N 91St Ave
C-101
Peoria, AZ 85381-3687 - Phone
- (623) 972-3992
- Fax
- (623) 974-9351
- NPI assigned
- May 3, 2006
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 13098 | AZ | Primary |
Addresses
Primary practice location
13943 N 91St Ave
C-101
Peoria, AZ 85381-3687
Mailing address
13943 N 91St Ave
C-101
Peoria, AZ 85381-3687
Phone (623) 972-3992
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0980615 | Other | AZ | AETNA |
| 1649238890 | Other | AZ | AHCCCCS |
| 070003050 | Other | AZ | RAILROAD MEDICARE |
| 99S007000005 | Other | AZ | MEDISUN |
| 099194 | Medicaid | AZ | |
| 1Z2340 | Other | AZ | HEALTHNET |
| 732136 | Other | AZ | UNITED HEALTHCARE |
| AZ0251140 | Other | AZ | BLUE CROSS BLUE SHIELD |
| 188961600 | Other | AZ | DEPT OF LABOR WORK COMP |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13098 | AZ | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1649238890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13943 N 91ST AVE",
"address_2": "C-101",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853813687",
"telephone_number": "623-972-3992",
"fax_number": "623-974-9351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13943 N 91ST AVE",
"address_2": "C-101",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853813687",
"telephone_number": "623-972-3992",
"fax_number": "623-974-9351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBENSTEIN",
"first_name": "DANIEL",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "AZ",
"license": "13098",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0980615",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCCS",
"identifier": "1649238890",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "070003050",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDISUN",
"identifier": "99S007000005",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "099194",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "1Z2340",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "732136",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0251140",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR WORK COMP",
"identifier": "188961600",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.