Organization Active NPI

Jeffrey M. Rubin, O.D., P.C.

  • Optometrist
  • Nanuet, NY
National Provider Identifier
1831218460
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003916 Issued in NY
Legal business name
JEFFREY M. RUBIN, O.D., P.C.
Practice address
55 Old Turnpike Rd
Suite 201
Nanuet, NY 10954-2461
Phone
(845) 623-3500
Fax
(845) 623-2223
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Dr. Jeffrey Martin Rubin, O.D.NPI 1396749651
Title
President
Phone
(845) 623-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 003916 NY Primary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 004168 NY
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X 003916 NY
Vision Therapy OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WV0400X 004168 NY

Addresses

Primary practice location

55 Old Turnpike Rd
Suite 201
Nanuet, NY 10954-2461

Mailing address

55 Old Turnpike Rd
Suite 201
Nanuet, NY 10954-2461
Phone (845) 623-3500

Other identifiers 7

IdentifierTypeStateIssuer
0092013OtherNYGHI
397349OtherNYEMPIRE
P1068808OtherNYOXFORD
5118769OtherCIGNA
C31061OtherNYBLUE CROSS
90580OtherUNITED HEALTHCARE
90580OtherNYAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110421000577 NY DME Supplier - Physician - Optometrist 8224213095 Practice locations: Nanuet, NY
O20110808000290 NY Part B Supplier - Clinic/Group Practice 8224213095 Receives reassigned benefits from 1 practitioner
Practice locations: Nanuet, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jeffrey M Rubin, OD, PC55 Old Turnpike Rd, Nanuet, NY 10954-2450(845) 623-3500 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jul 14, 2011

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1831218460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 OLD TURNPIKE RD",
            "address_2": "SUITE 201",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542461",
            "telephone_number": "845-623-3500",
            "fax_number": "845-623-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OLD TURNPIKE RD",
            "address_2": "SUITE 201",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542461",
            "telephone_number": "845-623-3500",
            "fax_number": "845-623-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M. RUBIN, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-623-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "003916",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "004168",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "003916",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "004168",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0092013",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "397349",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1068808",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5118769",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C31061",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "90580",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "90580",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.