Individual provider Active NPI

Eugene Bubis, ND, LDN

  • Nutritionist
  • Newton Highlands, MA
National Provider Identifier
1902950546
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
1911 Issued in MA
Practice address
1163 Walnut St
Suite 12
Newton Highlands, MA 02461-1265
Phone
(617) 965-1181
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1911 MA Primary
Registered Dietitian 133V00000X 1911 MA
Naturopath 175F00000X 1019 OR

Addresses

Primary practice location

1163 Walnut St
Suite 12
Newton Highlands, MA 02461-1265

Mailing address

1163 Walnut St
Suite 12
Newton Highlands, MA 02461-1265

Other identifiers 2

IdentifierTypeStateIssuer
AA23515OtherMAHARVARD PILGRIM
LD0082OtherMABCBSMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1911MAMDRegistered Dietitian
1019ORMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902950546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 WALNUT ST",
            "address_2": "SUITE 12",
            "city": "NEWTON HIGHLANDS",
            "state": "MA",
            "postal_code": "024611265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 WALNUT ST",
            "address_2": "SUITE 12",
            "city": "NEWTON HIGHLANDS",
            "state": "MA",
            "postal_code": "024611265",
            "telephone_number": "617-965-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBIS",
        "first_name": "EUGENE",
        "credential": "ND, LDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MA",
            "license": "1911",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1911",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1019",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA23515",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "LD0082",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton Highlands, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.