Individual provider Active NPI

Aviva Lubin, MD

  • Neurology Physician
  • Far Rockaway, NY
National Provider Identifier
1902066970
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
258489 Issued in NY
Practice address
327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone
(718) 869-7672
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 390200000X NY
Vascular Neurology Physician 2084V0102X 258489 NY
Neurology Physician 2084N0400X 258489 NY Primary

Addresses

Primary practice location

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Mailing address

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120404000494 NY Practitioner - NeurologyPractitioner - Internal MedicinePractitioner - Other (Physician) 7517127251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Icahn School of Medicine at Mount Sinai, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St John'S Medical Services PCGroup PAC ID 1850314865, 89 clinicians

Practice addresses (Care Compare)

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (718) 869-7919

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.83 of 100Reported as group
Quality
78.68
Promoting interoperability
98
Improvement activities
40
Cost
82.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
258489NYMDVascular Neurology Physician
390200000XNYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
St John'S Medical Services PC CurrentSince Nov 1, 2020 Accepting new patients

Locations

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

275 Rockaway Tpke
Lawrence, NY 11559
Phone (516) 371-2225

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

130 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

10538 Rockaway Beach Blvd
Rockaway Park, NY 11694
Phone (718) 318-3434

Networks

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

Interoperability endpoints

  • Direct secure messaging: aviva.lubin.1@14448.direct.athenahealth.com
  • Direct secure messaging: avivalubin@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1902066970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "718-869-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBIN",
        "first_name": "AVIVA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2020-11-09",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NY",
            "license": "258489",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "258489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.