NPIMap

Organization Active NPI

Associated Retinal Consultants, PC

  • Ophthalmology Physician
  • Grand Rapids, MI
National Provider Identifier
1407803414
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ASSOCIATED RETINAL CONSULTANTS, PC
Practice address
1179 E Paris Ave SE
250
Grand Rapids, MI 49546-3682
Phone
(616) 942-2406
Fax
(616) 942-1165
NPI assigned
May 27, 2006
Last updated
Jan 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
Alan Joel Ruby
Title
Owner
Phone
(248) 319-0161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1179 E Paris Ave SE
250
Grand Rapids, MI 49546-3682

Mailing address

2000 N Huron River Dr Ste 100
Ypsilanti, MI 48197-1600

Other identifiers 4

IdentifierTypeStateIssuer
791183369OtherMEDICARE RAILROAD GRP #
180Q26082OtherBCBS GRP #
G00698OtherBCN GRP #
38-146761OtherGRP TAX ID #

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2129826Associated Retinal Consultants, P C1179 E Paris, SE, Suite 250, Grand Rapids, MI 49546Certificate of waiverApr 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Associated Retinal Consultants PC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1179 East Paris Ave SE
Ste 250
Grand Rapids, MI 49546
Phone (616) 942-2406

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1407803414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N HURON RIVER DR STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 E PARIS AVE SE",
            "address_2": "250",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463682",
            "telephone_number": "616-942-2406",
            "fax_number": "616-942-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED RETINAL CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "RUBY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-319-0161"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GRP #",
            "identifier": "791183369",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP #",
            "identifier": "180Q26082",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GRP #",
            "identifier": "G00698",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP TAX ID #",
            "identifier": "38-146761",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.