NICOLE RUBIN (PA-C) – Family Medicine Physician, NPI 1265926059
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NICOLE RUBIN (PA-C)
14817 GLENMARK DR
EDMOND, OK 730131823
Phone: (623) 512-7405
Type: Mailing
921 NE 13TH ST
OKLAHOMA CITY, OK 731045007
Phone: (405) 456-1000
Type: Location
2919 S Division St
Guthrie, OK 730446806
Phone: (405) 282-6301
Type: Location
4801, Northwest 75th Street, Oklahoma City, Oklahoma County, Oklahoma, 73132, United States
OKLAHOMA CITY, OK 731325316
Phone: (623) 512-7405
Type: Mailing
Mercy Convenient Care - Guthrie Division, 2919, South Division Street, Guthrie, Logan County, Oklahoma, 73044, United States
GUTHRIE, OK 730446806
Phone: (405) 282-6301
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 27 Open Payments records for all available years, with a total value of $427.
Total Amount is formed as General ($427) + Research ($0) + Ownership ($0) = $427.
Last reported payment date: 2024-08-20 • Largest payer in this snapshot: PFIZER INC. ($96).
Total Amount
$427
General + Research + Ownership
Payments
27
Total payment records
General Amount
$427
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $96 |
| Novo Nordisk Inc | $76 |
| Lilly USA, LLC | $63 |
| ABBVIE INC. | $50 |
| GlaxoSmithKline, LLC. | $32 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-07-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180718003694 | I | Physician Assistant | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73013)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OK | |
| Family Practice | OK | |
| Family Practice | OK | |
| - | OK | |
| Internal Medicine | OK | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | OK | |
| Physician Assistant | OK |
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