Individual provider Active NPI

Moises Ilan Nevah Rubin, MD

  • Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1841482429
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
64415 Issued in AZ
Practice address
1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone
(602) 521-5800
Fax
(602) 521-0239
NPI assigned
Aug 16, 2007
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 64415 AZ
Internal Medicine Physician 207R00000X N2683 TX
Gastroenterology Physician 207RG0100X N2683 TX
Hepatology Physician 207RI0008X N2683 TX
Hepatology Physician 207RI0008X 64415 AZ
Transplant Hepatology Physician 207RT0003X 64415 AZ
Gastroenterology Physician 207RG0100X 64415 AZ Primary

Addresses

Primary practice location

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837

Mailing address

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone (602) 521-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20211006001370 AZ Practitioner - Gastroenterology 7113011552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Super Specialists LLCGroup PAC ID 1850695255, 31 clinicians

Practice addresses (Care Compare)

1441 N 12TH St
FL 2
Phoenix, AZ 85006-2837
Phone (844) 242-4664

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Upper gastrointestinal (GI) endoscopy for acid reflux16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64415AZMDGastroenterology Physician
N2683TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Sep 1, 2021 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Sep 1, 2021 Accepting new patients
Banner - University Super Specialists LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

1441 N 12th St
Fl 2AND3
Phoenix, AZ 85006

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

Interoperability endpoints

  • Direct secure messaging: moisesi.nevah@direct.memorialhermann.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1841482429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5800",
            "fax_number": "602-521-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5800",
            "fax_number": "602-521-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVAH RUBIN",
        "first_name": "MOISES",
        "middle_name": "ILAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "64415",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N2683",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "N2683",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "TX",
            "license": "N2683",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "AZ",
            "license": "64415",
            "primary": false
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "AZ",
            "license": "64415",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "64415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.