Individual provider Active NPI

Harvey Rubin, MD

  • Pediatric Adolescent Medicine Physician
  • Bridgeville, PA
National Provider Identifier
1841381365
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD009743E Issued in PA
Practice address
779 Marigold CT
Bridgeville, PA 15017-3807
Phone
(412) 275-3288
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X MD009743E PW
Pediatric Adolescent Medicine Physician 2080A0000X MD009743E PA Primary

Addresses

Primary practice location

779 Marigold CT
Bridgeville, PA 15017-3807

Mailing address

779 Marigold CT
Bridgeville, PA 15017-3807
Phone (412) 275-3288

Other identifiers 1

IdentifierTypeStateIssuer
0009374850002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160518000379 PA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9739478512

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD009743EPWMDNeonatal-Perinatal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1841381365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 MARIGOLD CT",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "150173807",
            "telephone_number": "412-275-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 MARIGOLD CT",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "150173807",
            "telephone_number": "412-275-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "HARVEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PW",
            "license": "MD009743E",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD009743E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009374850002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeville, PA

Sources for this page

Verify at the official NPI Registry.