Individual provider Active NPI

Vladimir Taub

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1992250997
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
340881 Issued in NY
Practice address
322 Lake Ave Ste 1
Rochester, NY 14608-1162
Phone
(585) 254-6480
NPI assigned
Aug 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 340881 NY Primary

Addresses

Primary practice location

322 Lake Ave Ste 1
Rochester, NY 14608-1162

Mailing address

322 Lake Ave Ste 1
Rochester, NY 14608-1162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170308001101 NY Practitioner - Nurse Practitioner 2264716471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Housing Works Services, Inc. CurrentSince May 1, 2022 Accepting new patients
Housing Works Services, Inc. CurrentSince May 1, 2022 Accepting new patients
Housing Works Services, Inc. PastSince May 1, 2022 Accepting new patients
Jordan Healthcare Center Past Accepting new patients

Locations

57 Willoughby St
Fl 2
Brooklyn, NY 11201
Phone (347) 473-7475

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1992250997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 LAKE AVE STE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 LAKE AVE STE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081162",
            "telephone_number": "585-254-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUB",
        "first_name": "VLADIMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.