Individual provider Active NPI

Marc Rubenstein, M.D

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1649298951
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
104676-1 Issued in NY
Practice address
110 W 97TH St
New York, NY 10025-6450
Phone
(212) 316-7923
Fax
(212) 316-7945
NPI assigned
Jul 17, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 104676-1 NY Primary

Addresses

Primary practice location

110 W 97TH St
New York, NY 10025-6450

Mailing address

110 W 97TH St
New York, NY 10025-6450
Phone (212) 316-7923

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130902000001 NY Practitioner - Internal Medicine 0941443428 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104676-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Aug 24, 2010 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Aug 24, 2010 Accepting new patients

Locations

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

110 W 97th St
#0
New York, NY 10025

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649298951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256450",
            "telephone_number": "212-316-7923",
            "fax_number": "212-316-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W 97TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256450",
            "telephone_number": "212-316-7923",
            "fax_number": "212-316-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBENSTEIN",
        "first_name": "MARC",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "104676-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.