Individual provider Active NPI

Ida Jean Rubino, MD

  • Family Medicine Physician
  • Sterling Heights, MI
National Provider Identifier
1073626594
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301060062 Issued in MI
Practice address
44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone
(248) 964-0400
Fax
(248) 964-0402
NPI assigned
Aug 17, 2006
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301060062 MI Primary

Addresses

Primary practice location

44250 Dequindre Rd
Sterling Heights, MI 48314-1002

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other identifiers 1

IdentifierTypeStateIssuer
3403008MedicaidMI

Other names 1

  • Ida Jean Rubino-Ricci Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address irubino15841@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000258 MI Practitioner - Family Practice 5799688172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone (248) 964-0400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Family Medicine CurrentSince May 16, 2018 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince May 16, 2018 Accepting new patients
William Beaumont Hospital Current Accepting new patients
William Beaumont Hospital Family Medicine CurrentSince Jun 1, 2003 Accepting new patients
William Beaumont Hospital CurrentSince Jun 1, 2003 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

3535 W 13 Mile Rd
Ste 447
Royal Oak, MI 48073
Phone (248) 551-2091

3601 W 13 Mile Rd
Royal Oak, MI 48073

3601 W 13 Mile Rd
#400
Royal Oak, MI 48073
Phone (248) 423-2481

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

30503 Greenfield Rd
Southfield, MI 48076
Phone (248) 691-4744

21400 E 11 Mile Rd
St Clr Shores, MI 48081
Phone (586) 498-4400

44250 Dequindre Rd
Sterling Hts, MI 48314
Phone (248) 964-0400

44300 Dequindre Rd
Sterling Hts, MI 48314
Phone (248) 964-0100

130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: irubino15841@direct.beaumont.edu

Organizations & group practices 6

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 4

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1073626594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44250 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141002",
            "telephone_number": "248-964-0400",
            "fax_number": "248-964-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "IDA",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301060062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3403008",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "irubino15841@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44250 Dequindre Rd",
            "city": "Sterling Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483141002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "IDA",
            "last_name": "RUBINO-RICCI",
            "middle_name": "JEAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.