Organization Active NPI

DRS Rubin and Simonian PC

  • Ophthalmology Physician
  • Madison Heights, MI
National Provider Identifier
1548444565
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DRS RUBIN AND SIMONIAN PC
Doing business as
AFFILIATED EYE SURGENS
Practice address
1421 E. 12 Mile
BLDG. a
Madison Heights, MI 48071-2653
Phone
(248) 547-6656
Fax
(248) 547-5407
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Sidney K Simonian, D.O.NPI 1902849045
Title
Doctor
Phone
(248) 547-6656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X MI Primary

Addresses

Primary practice location

1421 E. 12 Mile
BLDG. a
Madison Heights, MI 48071-2653

Mailing address

1421 E. 12 Mile
BLDG. a
Madison Heights, MI 48071-2653
Phone (248) 547-6656

Other identifiers 5

IdentifierTypeStateIssuer
139455411MedicaidMI
8631110001OtherMIMRPB
180008618OtherMIMRRR
1856303004OtherMIBCBS
1856303004OtherMIBCN

Other names 1

  • AFFILIATED EYE SURGENS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100914000211 MI Part B Supplier - Clinic/Group Practice 6901921030 Receives reassigned benefits from 2 practitioners
Practice locations: Madison Heights, MI

National Provider Directory

National Provider Directory

Locations

1421 E 12 Mile Rd
Bldg A
Madison Heights, MI 48071
Phone (248) 547-6656

1421 E 12 Mile Rd
Madison Heights, MI 48071

27483 Dequindre Rd
Ste 303B
Madison Hts, MI 48071
Phone (248) 541-6656

950 N Cass Lake Rd
Ste 104
Waterford, MI 48328
Phone (248) 681-4900

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1548444565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E. 12 MILE",
            "address_2": "BLDG. A",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712653",
            "telephone_number": "248-547-6656",
            "fax_number": "248-547-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E. 12 MILE",
            "address_2": "BLDG. A",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712653",
            "telephone_number": "248-547-6656",
            "fax_number": "248-547-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS RUBIN AND SIMONIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SIMONIAN",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "248-547-6656",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139455411",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MRPB",
            "identifier": "8631110001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MRRR",
            "identifier": "180008618",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1856303004",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "1856303004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFFILIATED EYE SURGENS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.