Kenneth J Rubin, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA03317200 Issued in NJ

Practice address

170 Morris Ave
D
Long Branch, NJ 07740-8214

Phone

(732) 870-3535

Fax

(732) 870-8253

NPI assigned

Aug 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenneth J Rubin MD PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Long Branch, NJ
  • NPI 1649580820
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699881896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MORRIS AVE",
            "address_2": "D",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077408214",
            "telephone_number": "732-870-3535",
            "fax_number": "732-870-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORRIS AVE",
            "address_2": "D",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077408214",
            "telephone_number": "732-870-3535",
            "fax_number": "732-870-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA03317200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2915405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter Rose, MD
• Joel S Ross, MD
• Madison Leigh Rothman
• Jan Mark Lester Vilela Roxas, MD
• Royal Home Health Care, LLC
• Barry P Rubino, MD
• Danielle Ruda, DMD
• Russell M. Holstein, PH.D., LLC
• Lauren Elizabeth Russo, DO
• Teresa A Ryan, PT

• Psychiatry Physician in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Psychiatry Physician in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.