NPIMap

Individual provider Active NPI

Timothy Alan Rubin, MD

  • Gastroenterology Physician
  • Duluth, MN
National Provider Identifier
1801830856
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
37514 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Jun 16, 2006
Last updated
May 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 37514 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other identifiers 1

IdentifierTypeStateIssuer
647824700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060823000535 WI Practitioner - Gastroenterology 8224031729 Reassigns benefits to 3 organizations
I20100413000057 MN Practitioner - Gastroenterology 8224031729 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Minnesota Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, shared by 25 NPIs, 1,135 clinicians

Practice addresses (Care Compare)

1502 London Rd
Suite 102
Duluth, MN 55812-1787
Phone (218) 727-8228

400 E 3Rd St
Duluth, MN 55805-1951

502 E 2ND St
Duluth, MN 55805-1913

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48
Upper gastrointestinal (GI) endoscopy for acid reflux98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Essentia Health Virginia, LLC CurrentSince Dec 1, 2016 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
The Duluth Clinic, LTD CurrentSince May 9, 2011 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 19, 2002 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
Essentia Health Virginia, LLC CurrentSince Dec 1, 2016 Accepting new patients
St. Joseph's Medical Center CurrentSince Jan 1, 2022 Accepting new patients
St Joseph's Medical Center CurrentSince Jan 1, 2022 Accepting new patients
St. Joseph's Medical Center Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Aug 17, 2012 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Essentia Health Virginia, LLC CurrentSince Aug 19, 2002 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

1502 London Rd
Ste 102
Duluth, MN 55812
Phone (218) 576-0100

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

300 W Conan St
Ely, MN 55731
Phone (218) 365-7900

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

15495 County Road B
Hayward, WI 54843
Phone (715) 634-2641

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

3500 Tower Ave
#1
Superior, WI 54880
Phone (715) 395-5457

3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1801830856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "37514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "647824700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.