Individual provider Active NPI

Madeline Elizabeth Rubin, LCSW

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1801009311
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0175 Issued in OR
Practice address
216 SW Madison Avenue
Suite 14
Corvallis, OR 97333
Phone
(541) 758-7332
Fax
(541) 754-7459
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0175 OR Primary

Addresses

Primary practice location

216 SW Madison Avenue
Suite 14
Corvallis, OR 97333

Mailing address

PO Box 1593
Corvallis, OR 97339
Phone (541) 758-7332

Other identifiers 1

IdentifierTypeStateIssuer
005076OtherORVALUE OPTIONS EAP

Other names 1

  • Madeline Elizabeth Rubin Hemmer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090527000425 OR Practitioner - Clinical Social Worker 1254480015 Practice locations: Corvallis, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

216 SW Madison Ave
Corvallis, OR 97333-4721
Phone (541) 758-7332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0175ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801009311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1593",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97339",
            "telephone_number": "541-758-7332",
            "fax_number": "541-754-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SW MADISON AVENUE",
            "address_2": "SUITE 14",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97333",
            "telephone_number": "541-758-7332",
            "fax_number": "541-754-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "MADELINE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "0175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS EAP",
            "identifier": "005076",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "RUBIN HEMMER",
            "middle_name": "ELIZABETH",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.