NPIMap

Individual provider Active NPI

Oleg F Rubin, MD

  • Nephrology Physician
  • Fairfield, CA
National Provider Identifier
1790762763
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A81462 Issued in CA
Practice address
1411 Oliver Rd Ste 250
Fairfield, CA 94534-3425
Phone
(707) 426-5407
Fax
(707) 426-6376
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A81462 CA
Nephrology Physician 207RN0300X A81462 CA Primary

Addresses

Primary practice location

1411 Oliver Rd Ste 250
Fairfield, CA 94534-3425

Mailing address

1411 Oliver Rd Ste 250
Fairfield, CA 94534-3425
Phone (707) 426-5407

Other identifiers 2

IdentifierTypeStateIssuer
00A814620MedicaidCA
ZZZ27071ZOtherCAMEDICARE CA NORTH GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050707000082 CA Practitioner - NephrologyPractitioner - Internal Medicine 9638115041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ong Rubin Shahmir a Medical CorporationGroup PAC ID 7315123007, 6 clinicians

Practice addresses (Care Compare)

1411 Oliver Rd
Suite 250
Fairfield, CA 94534-3425
Phone (707) 426-5407

Hospital & facility affiliations

  • DaVita Fairfield Downtown Dialysis Dialysis facility, Fairfield, CA, CCN 552763
  • DaVita SUNFLOWER HOME TRAINING Dialysis facility, Fairfield, CA, CCN 752612
  • DaVita Fairfield Dialysis Center Dialysis facility, Fairfield, CA, CCN 052618
  • DaVita Delta View Dialysis Dialysis facility, Pittsburg, CA, CCN 552664
  • Northbay Medical Center Hospital, Fairfield, CA, CCN 050367
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81462CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ong Rubin Shahmir a Medical Corporation Nephrology CurrentSince Apr 1, 2011 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Northbay Healthcare Group Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Ubonsie Dialysis, LLC PastSince Mar 1, 2021 Accepting new patients

Locations

1411 Oliver Rd
Ste 250
Fairfield, CA 94534
Phone (707) 426-5407

1261 Travis Blvd
Ste 150
Fairfield, CA 94533
Phone (707) 426-4696

1360 Burton Dr
Ste 160
Vacaville, CA 95687
Phone (707) 446-4379

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1790762763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 OLIVER RD STE 250",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343425",
            "telephone_number": "707-426-5407",
            "fax_number": "707-426-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 OLIVER RD STE 250",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343425",
            "telephone_number": "707-426-5407",
            "fax_number": "707-426-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "OLEG",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A81462",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A81462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A814620",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CA NORTH GROUP",
            "identifier": "ZZZ27071Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.