Robert Daniel Rubin, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

250324 Issued in NY

Practice address

496 County Road 111
BLDG B
Manorville, NY 11949-3383

Phone

(631) 405-3200

Fax

(631) 395-6010

NPI assigned

Aug 30, 2007

Last updated

Dec 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: rrubin28062@northwell.direct-ci.com

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.

• Peconic Bay Primary Medical Care

  dba Same

  • Internal Medicine Physician
  • Mattituck, NY
  • NPI 1487620613
  Medicare reassignment NPD
• Central Suffolk Hospital

  dba Peconic Bay Medical Center Professional Group Practice

  • Hospitalist Physician
  • Riverhead, NY
  • NPI 1043402050
  NPD (past)
• Central Suffolk Hospital

  dba Peconic Bay Medical Center

  • General Acute Care Hospital
  • Riverhead, NY
  • NPI 1386649804
  NPD (past)

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1821282054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 OLD COUNTRY RD",
            "address_2": "SUITE 2",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012121",
            "telephone_number": "631-298-4479",
            "fax_number": "631-591-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 COUNTY ROAD 111",
            "address_2": "BLDG B",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493383",
            "telephone_number": "631-405-3200",
            "fax_number": "631-395-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "ROBERT",
        "middle_name": "DANIEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "250324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Riegel
• Claire Ann Roberts, MS CCC SLP
• Jennifer Rogan, OTR/L
• Lori Ann Rosenbaum
• Heather I Ross, LAC
• Tina Ruggiero, PH.D.
• Dawn Michelle Russo-Sperandio, TEACHER
• Carmen Ruvola
• Peter J Saccone, D.C
• Daniel M Salaway, MS, MT-BC, LCAT

• Pediatrics Physician in Manorville, NY
• Providers in Manorville, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.