NPIMap

Organization Active NPI

Laureen Forgione Rubino, M.D., LLC

  • Specialist
  • Manchester, CT
National Provider Identifier
1962429969
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
033061 Issued in CT
Legal business name
LAUREEN FORGIONE RUBINO, M.D., LLC
Practice address
945 Main St Ste 105
Manchester, CT 06040-6064
Phone
(860) 645-1232
Fax
(860) 647-0438
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Dr. Laureen Forgione Rubino, M.D.NPI 1457388183
Title
President
Phone
(860) 645-1232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 033061 CT Primary

Addresses

Primary practice location

945 Main St Ste 105
Manchester, CT 06040-6064

Mailing address

945 Main St Ste 105
Manchester, CT 06040-6064
Phone (860) 645-1232

Other identifiers 15

IdentifierTypeStateIssuer
010033061CT01OtherCTANTHEM BC/BS
020046417OtherCTRAILROADMEDICARE
010036834CT01OtherCTANTHEM BC/BS
033061OtherCTCONNECTICARE
2225252OtherCTAETNA
OV5259OtherCTHEALTH NET
00136834000MedicaidCT
036834OtherCTCONNECTICARE
3716523OtherCTAETNA
2V6079OtherCTHEALTHNET
P1991984OtherCTOXFORD
00133061200MedicaidCT
P3564749OtherCTOXFORD
3788171OtherCTCIGNA
5664714002OtherCTCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050728001038 CT Part B Supplier - Clinic/Group Practice 0143258400 Receives reassigned benefits from 1 practitioner
Practice locations: Manchester, CT

National Provider Directory

National Provider Directory

Locations

43 W Main St
Ste 8
Vernon Rockville, CT 06066

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1962429969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 MAIN ST STE 105",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406064",
            "telephone_number": "860-645-1232",
            "fax_number": "860-647-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 MAIN ST STE 105",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406064",
            "telephone_number": "860-645-1232",
            "fax_number": "860-647-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREEN FORGIONE RUBINO, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "FORGIONE RUBINO",
        "authorized_official_first_name": "LAUREEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-645-1232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": "033061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "010033061CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROADMEDICARE",
            "identifier": "020046417",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "010036834CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "033061",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2225252",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "OV5259",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00136834000",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "036834",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3716523",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V6079",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1991984",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00133061200",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3564749",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3788171",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5664714002",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.