Individual provider Active NPI

Vadim Rubin, M.D.

  • Nephrology Physician
  • Teaneck, NJ
National Provider Identifier
1922405042
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA11634400 Issued in NJ
Practice address
870 Palisade Avenue
Suite 202
Teaneck, NJ 07666
Phone
(551) 996-9189
NPI assigned
Dec 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 281174 NY
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 25MA11634400 NJ Primary

Addresses

Primary practice location

870 Palisade Avenue
Suite 202
Teaneck, NJ 07666

Mailing address

870 Palisade Avenue
Suite 202
Teaneck, NJ 07666
Phone (551) 996-9189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151013001089 NY Practitioner - NephrologyPractitioner - Internal Medicine 8224347307 Reassigns benefits to 4 organizations
I20221229001824 NJ Practitioner - Nephrology 8224347307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

1 Brookdale PLZ
Brooklyn, NY 11212-3198

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

Hospital & facility affiliations

  • Lincoln Hospital Dialysis facility, Bronx, NY, CCN 332394
  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233
  • Lincoln Medical & Mental Health Center Hospital, Bronx, NY, CCN 330080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11634400NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC Single Specialty CurrentSince Aug 4, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Single Specialty CurrentSince Nov 1, 2022 Accepting new patients
Interfaith Professional Physician Services, P.C. Single Specialty CurrentSince Feb 1, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jul 1, 2015 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Single Specialty CurrentSince Nov 1, 2022 Accepting new patients
Brookdale Hospital Medical Center Single Specialty CurrentSince Jul 1, 2015 Accepting new patients
Downtown Bronx Medical Associates PC Single Specialty CurrentSince Dec 13, 2023 Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients

Locations

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

870 Palisade Ave
Teaneck, NJ 07666
Phone (201) 907-0900

870 Palisade Ave
Ste 202
Teaneck, NJ 07666
Phone (201) 836-0897

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1335 Linden Blvd
Ste 100
Brooklyn, NY 11212
Phone (718) 240-5100

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: vrubin3919454@nychhc.direct-ci.com
  • Direct secure messaging: vadim.rubin@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1922405042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVENUE",
            "address_2": "SUITE 202",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "551-996-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVENUE",
            "address_2": "SUITE 202",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "551-996-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "VADIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-04",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "281174",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA11634400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.