Mary Ellen Rubin, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

005749-1 Issued in NY

Practice address

6245 Sheridan Dr
Suite 218
Williamsville, NY 14221-4834

Phone

(716) 632-5563

NPI assigned

Sep 1, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962496240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 GETZVILLE RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142263519",
            "telephone_number": "716-632-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 SHERIDAN DR",
            "address_2": "SUITE 218",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214834",
            "telephone_number": "716-632-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "MARY ELLEN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "005749-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000507521001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myles W Rowan, PT, DPT
• Noelle Rowlinson, PNP
• Grzegorz P Rozmus, MD
• Charles Anthony Rozo, RPH
• Rpci Oncology PC
• Stuart Rubin, MD
• Andrea Maria Rubino, BS, PHARM D
• Kaya Rose Rucci, MHC-P
• Luisa Daniela Ruck, D.O.
• Sheana Rudolph, LPN

• Clinical Psychologist in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.