Individual provider Active NPI

Patrick E Rubsamen, MD

  • Retina Specialist (Ophthalmology) Physician
  • Fort Lauderdale, FL
National Provider Identifier
1215935382
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
ME50471 Issued in FL
Practice address
6333 N Federal Hwy
Suite 300
Ft Lauderdale, FL 33308-1907
Phone
(954) 776-6880
Fax
(954) 229-3100
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME50471 FL
Retina Specialist (Ophthalmology) Physician 207WX0107X ME50471 FL Primary

Addresses

Primary practice location

6333 N Federal Hwy
Suite 300
Ft Lauderdale, FL 33308-1907

Mailing address

6333 N Federal Hwy
Suite 300
Ft Lauderdale, FL 33308-1907
Phone (954) 776-6880

Other identifiers 2

IdentifierTypeStateIssuer
10128OtherFLBCBSFL
063247300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000858 FL Practitioner - Ophthalmology 2769446483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Vitreous Consultants Ophthalmology CurrentSince Jun 1, 1999 Accepting new patients
University of Miami Ophthalmology Past Accepting new patients
Miami Lakes Eye Care Center PA Ophthalmology PastSince Sep 16, 2003 Accepting new patients
Kevin T Kelly M D PA Ophthalmology PastSince Jun 1, 1999 Accepting new patients
Bedotto Wallace Clewner & Kelly, MD, PA Ophthalmology PastSince Sep 15, 1999 Accepting new patients

Locations

950 Glades Rd
Ste 1C
Boca Raton, FL 33431
Phone (305) 294-5504

6333 N Federal Hwy
Ste 300
Ft Lauderdale, FL 33308
Phone (954) 776-6880

1708 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 294-5503

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1215935382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 N FEDERAL HWY",
            "address_2": "SUITE 300",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081907",
            "telephone_number": "954-776-6880",
            "fax_number": "954-229-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 N FEDERAL HWY",
            "address_2": "SUITE 300",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081907",
            "telephone_number": "954-776-6880",
            "fax_number": "954-229-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBSAMEN",
        "first_name": "PATRICK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME50471",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME50471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "10128",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063247300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.