Individual provider Active NPI

Allan M Rubin, MD

  • Otolaryngology Physician
  • Sylvania, OH
National Provider Identifier
1528060456
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35055273 Issued in OH
Practice address
5300 Harroun Rd
Suite 118
Sylvania, OH 43560-2182
Phone
(419) 824-1399
Fax
(419) 824-1455
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35055273 OH Primary

Addresses

Primary practice location

5300 Harroun Rd
Suite 118
Sylvania, OH 43560-2182

Mailing address

5300 Harroun Rd
Suite 118
Sylvania, OH 43560-2182
Phone (419) 824-1399

Other identifiers 12

IdentifierTypeStateIssuer
4198375OtherOHAETNA
503130025-00OtherOHBWC
000000317260OtherOHANTHEM
502130025-022OtherOHMMO
503130025-018OtherOHMMO
P00090521OtherOHRRMC
503130025-020OtherOHMMO
0658659OtherOHBCMH
910658OtherOHUHC
01140OtherOHPARAMOUNT
0658659MedicaidOH
503130025OtherOHHNFS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address arubin13622@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040414000789 OH Practitioner - Otolaryngology 4284539982 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35055273OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Otolaryngology CurrentSince Jan 1, 2015 Accepting new patients
Promedica Central Physicians CurrentSince Jan 1, 2015 Accepting new patients
University of Toledo Physicians LLC Past Accepting new patients
Emma L. Bixby Medical Center Past Accepting new patients
University of Toledo Physicians, LLC Past Accepting new patients
Pharmacy Counter LLC PastSince Feb 1, 2011 Accepting new patients
Bixby Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

650 Beaver Creek Cir
Ste 130
Maumee, OH 43537
Phone (419) 891-6210

2751 Bay Park Dr
Ste 300
Oregon, OH 43616
Phone (419) 690-7596

900 W South Boundary St
Bldg 9A
Perrysburg, OH 43551
Phone (419) 872-3010

5300 Harroun Rd
Ste 218
Sylvania, OH 43560
Phone (419) 824-1399

5308 Harroun Rd
Ste 160
Sylvania, OH 43560
Phone (419) 824-5668

5300 Harroun Rd
Ste 118
Sylvania, OH 43560
Phone (419) 479-5386

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

2121 Hughes Dr
Ste 710
Toledo, OH 43606
Phone (419) 291-2610

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9641/brand/2/csg/1/fhir/r4

Organizations & group practices 8

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1528060456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD",
            "address_2": "SUITE 118",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602182",
            "telephone_number": "419-824-1399",
            "fax_number": "419-824-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD",
            "address_2": "SUITE 118",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602182",
            "telephone_number": "419-824-1399",
            "fax_number": "419-824-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "ALLAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35055273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4198375",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "503130025-00",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000317260",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMO",
            "identifier": "502130025-022",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMO",
            "identifier": "503130025-018",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00090521",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMO",
            "identifier": "503130025-020",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0658659",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "910658",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "01140",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0658659",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HNFS",
            "identifier": "503130025",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arubin13622@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.