Active NPI
Mark Rubinstein
- Clinical Social Worker
- Pawtucket, RI
National Provider Identifier
1720005572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW00428
- Practice address
- 1070 Main St
Pawtucket, RI 02860-4847 - Phone
- (401) 727-6490
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW00428 | RI | Primary |
Addresses
Primary practice location
1070 Main St
Pawtucket, RI 02860-4847
Mailing address
951 N Main St
Providence, RI 02904-5759
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62-34029 | Other | RI | UNITED BEHAVIORAL HEALTH |
| 003885 | Other | RI | BLUE CHIP |
| 30880-9 | Other | RI | BLUE CROSS |
| MR30699 | Medicaid | RI |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW00428 | RI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center Inc | Clinical | Past | Accepting new patients |
| The Providence Center | Past | Accepting new patients |
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.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Providence, RI
- NPI 1609818210
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Providence, RI
- NPI 1104847946
Clinical
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": "1720005572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1070 MAIN ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604847",
"telephone_number": "401-727-6490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBINSTEIN",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW00428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "62-34029",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "003885",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "30880-9",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MR30699",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.