NPIMap

Individual provider Active NPI

Gerry Rubin, MD

  • Hematology & Oncology Physician
  • Bay Shore, NY
National Provider Identifier
1982677761
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
177178 Issued in NY
Practice address
180 E Main St
Bay Shore, NY 11706-8427
Phone
(631) 751-3000
Fax
(631) 675-2001
NPI assigned
Feb 10, 2006
Last updated
Aug 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 177178 NY Primary

Addresses

Primary practice location

180 E Main St
Bay Shore, NY 11706-8427

Mailing address

1500 Route 112 BLDG 4
Suite101
Port Jefferson Station, NY 11776-3456
Phone (631) 574-8354

Other identifiers 1

IdentifierTypeStateIssuer
02023150MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000027 NY Practitioner - Hematology/Oncology 6608043245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Rutgers New Jersey Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

375 E Main St
Suite 21
Bay Shore, NY 11706-8418
Phone (631) 751-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177178NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince May 4, 2015 Accepting new patients
Peninsula Medical Services PC Past Accepting new patients

Locations

72 E Main St
Babylon, NY 11702

180 E Main St
Ste 5
Bay Shore, NY 11706
Phone (631) 666-0262

375 E Main St
Ste 21
Bay Shore, NY 11706
Phone (516) 968-8288

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

235 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 450-1200

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1982677761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 BLDG 4",
            "address_2": "SUITE101",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763456",
            "telephone_number": "631-574-8354",
            "fax_number": "631-509-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068427",
            "telephone_number": "631-751-3000",
            "fax_number": "631-675-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "GERRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "177178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02023150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.