Individual provider Active NPI

Paul Ruberg

  • Physician Assistant
  • Fairfax, VA
National Provider Identifier
1801438536
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110007711 Issued in VA
Practice address
3930 Pender Dr Ste 120
Fairfax, VA 22030-0986
Phone
(703) 865-8686
NPI assigned
Oct 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP01015600 NJ
Physician Assistant 363A00000X 0110007711 VA Primary
Physician Assistant 363A00000X PA9121752 FL
Physician Assistant 363A00000X MA067671 PA

Addresses

Primary practice location

3930 Pender Dr Ste 120
Fairfax, VA 22030-0986

Mailing address

3930 Pender Dr Ste 120
Fairfax, VA 22030-0986
Phone (703) 865-8686

Other practice location 1

5725 Forward Ave Ste 401
Pittsburgh, PA 15217-2255
Phone (412) 214-0042

Other practice location 2

100 High Tower Blvd Ste 200
Pittsburgh, PA 15205-1134
Phone (412) 214-0042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220323001799 DC Practitioner - Physician Assistant 3476948746 Reassigns benefits to 2 organizations
I20230217001942 VA Practitioner - Physician Assistant 3476948746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuropsych Wellness Center, PCGroup PAC ID 9335271725, 22 clinicians

Practice addresses (Care Compare)

3930 Pender Dr
Suite 240
Fairfax, VA 22030-0986
Phone (703) 865-8686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9121752FLMDPhysician Assistant
25MP01015600NJMDPhysician Assistant
MA067671PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Nexus Group PC Past Accepting new patients

Organizations & group practices 3

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1801438536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 PENDER DR STE 120",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220300986",
            "telephone_number": "703-865-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 PENDER DR STE 120",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220300986",
            "telephone_number": "703-865-8686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5725 Forward Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152172255",
            "country_code": "US",
            "telephone_number": "412-214-0042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 High Tower Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152051134",
            "country_code": "US",
            "telephone_number": "412-214-0042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBERG",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-15",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP01015600",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007711",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121752",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA067671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.