Individual provider Active NPI

Brent Lane Rubin, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lakewood Ranch, FL
National Provider Identifier
1821091422
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3236 Issued in FL
Practice address
14911 Bowfin Ter
Lakewood Ranch, FL 34202-5822
Phone
(941) 448-9178
Fax
(941) 580-6670
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3236 FL Primary

Addresses

Primary practice location

14911 Bowfin Ter
Lakewood Ranch, FL 34202-5822

Mailing address

14911 Bowfin Ter
Lakewood Ranch, FL 34202-5822
Phone (941) 448-9178

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161104001137 FL Order and Referring Only - PodiatryPractitioner - Podiatry 0648274860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brent L. Rubin & Associates Inc Podiatrist PastSince Aug 11, 2019 Accepting new patients
Brent L. Rubin & Associates Inc Podiatrist PastSince Jul 1, 1997 Accepting new patients
Healthcare America Medical Group, Inc. Podiatrist 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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1821091422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14911 BOWFIN TER",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025822",
            "telephone_number": "941-448-9178",
            "fax_number": "941-580-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14911 BOWFIN TER",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025822",
            "telephone_number": "941-448-9178",
            "fax_number": "941-580-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "BRENT",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.