Individual provider Active NPI

Juan R Rubero, MD

  • Internal Medicine Physician
  • Sacramento, CA
National Provider Identifier
1700916194
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
017518 Issued in ME
Practice address
2500 Marconi Ave Ste 100
Sacramento, CA 95821-4856
Phone
(916) 485-4175
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 017518 ME Primary

Addresses

Primary practice location

2500 Marconi Ave Ste 100
Sacramento, CA 95821-4856

Mailing address

2500 Marconi Ave Ste 100
Sacramento, CA 95821-4856
Phone (916) 485-4175

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sustainable Wellness Solutions CurrentSince Mar 4, 2021 Accepting new patients
Central Maine Clinical Associates Past Accepting new patients
Central Maine Medical Center Past Accepting new patients
Central Maine Clinical Associates Corporation Past Accepting new patients

Locations

2500 Marconi Ave
Ste 100
Sacramento, CA 95821
Phone (916) 628-0848

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 4

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1700916194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARCONI AVE STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214856",
            "telephone_number": "916-485-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MARCONI AVE STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214856",
            "telephone_number": "916-485-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBERO",
        "first_name": "JUAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "017518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.