Individual provider Active NPI

Kimberley Marie Rubino, PA-C

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1760962328
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022422 Issued in NY
Practice address
953 Southern Blvd
Bronx, NY 10459-3428
Phone
(347) 739-0677
NPI assigned
Aug 14, 2018
Last updated
Jul 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022422 NY Primary

Addresses

Primary practice location

953 Southern Blvd
Bronx, NY 10459-3428

Mailing address

953 Southern Blvd
Bronx, NY 10459-3428
Phone (347) 326-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191104002180 CT Practitioner - Physician Assistant 4880926211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Contemporary Care LLCGroup PAC ID 9537408141, 30 clinicians

Practice addresses (Care Compare)

81 Holly Hill LN
FL 2
Greenwich, CT 06830-6071
Phone (203) 792-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022422NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Contemporary Care, LLC CurrentSince Sep 18, 2019 Accepting new patients

Locations

84 Hospital Ave
Danbury, CT 06810
Phone (203) 792-0400

81 Holly Hill Ln
Fl 2
Greenwich, CT 06830
Phone (203) 321-5063

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1760962328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593428",
            "telephone_number": "347-326-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593428",
            "telephone_number": "347-739-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "KIMBERLEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.