Individual provider Active NPI

Rashawn Winfred Venerable, D.O.

  • Ophthalmology Physician
  • Adrian, MI
National Provider Identifier
1720164973
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
5101015354 Issued in MI
Practice address
1801 W Maumee St Ste 100
Adrian, MI 49221-1291
Phone
(517) 265-6131
Fax
(517) 265-7326
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X RV015354 MI
Ophthalmology Physician 207W00000X 5101015354 MI Primary

Addresses

Primary practice location

1801 W Maumee St Ste 100
Adrian, MI 49221-1291

Mailing address

850 W North St Ste 104
Jackson, MI 49202-3196
Phone (877) 852-8463

Other identifiers 1

IdentifierTypeStateIssuer
4910917MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061204000125 MI Practitioner - Ophthalmology 8224037130 Reassigns benefits to 1 organization
I20140604002156 OH Practitioner - Ophthalmology 8224037130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS Ravin Birndorf and Ravin IncGroup PAC ID 2860487964, 7 clinicians

Practice addresses (Care Compare)

1801 W Maumee St
Suite 100
Adrian, MI 49221-1291
Phone (517) 265-6131

3000 Regency CT
Suite 100
Toledo, OH 43623-3081
Phone (800) 832-2015

Hospital & facility affiliations

  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
98.78
Promoting interoperability
53
Improvement activities
40
Cost
76.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery278
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RV015354MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Ravin, Birndorf & Ravin, Inc. Optometrist CurrentSince Jan 18, 2012 Accepting new patients
Mid Michigan Eye Care Center, PC Optometrist PastSince Mar 23, 2014 Accepting new patients

Locations

1801 W Maumee St
Ste 100
Adrian, MI 49221
Phone (517) 265-6131

850 W North St
#104
Jackson, MI 49202
Phone (248) 647-9790

100 S Lynn St
Bryan, OH 43506
Phone (419) 636-0440

3000 Regency Ct
Ste 100
Toledo, OH 43623
Phone (419) 882-2020

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1720164973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W NORTH ST STE 104",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023196",
            "telephone_number": "877-852-8463",
            "fax_number": "517-817-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W MAUMEE ST STE 100",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211291",
            "telephone_number": "517-265-6131",
            "fax_number": "517-265-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENERABLE",
        "first_name": "RASHAWN",
        "middle_name": "WINFRED",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "RV015354",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "5101015354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4910917",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.