Individual provider Active NPI

Mariam S Rubbani, MD

  • Specialist
  • Newark, NJ
National Provider Identifier
1801939723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA07566500 Issued in NJ
Practice address
550 Bloomfield Ave
Newark, NJ 07107-1386
Phone
(973) 483-1500
Fax
(973) 483-4577
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
Yes

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
Specialist 174400000X 25MA07566500 NJ Primary

Addresses

Primary practice location

550 Bloomfield Ave
Newark, NJ 07107-1386

Mailing address

PO Box 24008
Jersey City, NJ 07304-0701
Phone (973) 483-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07566500NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Spine & Rehab PastSince Jul 29, 2005 Accepting new patients
Astra MD P C PastSince Jul 7, 2011 Accepting new patients
Hudson MD Group Past Accepting new patients
Atlantic Rehabilitation Medicine Associates PA PastSince Oct 22, 2023 Accepting new patients
South Shore Medical Care &Diagnostic, PC Past Accepting new patients

Organizations & group practices 5

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801939723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24008",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073040701",
            "telephone_number": "973-483-1500",
            "fax_number": "973-483-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 BLOOMFIELD AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071386",
            "telephone_number": "973-483-1500",
            "fax_number": "973-483-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBBANI",
        "first_name": "MARIAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07566500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.