Individual provider Active NPI

Rudyna Beydoun, OD

  • Optometrist
  • Taylor, MI
National Provider Identifier
1902377765
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005169 Issued in MI
Practice address
23000 Eureka Rd
Taylor, MI 48180-6039
Phone
(734) 374-8500
Fax
(734) 374-0957
NPI assigned
Dec 5, 2018
Last updated
Dec 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005169 MI Primary

Addresses

Primary practice location

23000 Eureka Rd
Taylor, MI 48180-6039

Mailing address

23728 Cherry Hill St
Dearborn, MI 48124-1418
Phone (914) 588-3196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210604001632 MI Practitioner - Optometry 1658770011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Point Optical GroupGroup PAC ID 9032491246, 28 clinicians

Practice addresses (Care Compare)

1736 W Michigan Ave
Jackson, MI 49202-4005
Phone (517) 789-7131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fortney Eyecare Associates Inc Optometrist CurrentSince Mar 5, 2021 Accepting new patients
West Point Optical Group Optometrist CurrentSince Mar 27, 2024 Accepting new patients
West Point Optical Group Optometrist Past Accepting new patients
West Point Optical Group Optometrist Past Accepting new patients

Locations

654 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 761-8300

23469 Michigan Ave
Dearborn, MI 48124
Phone (313) 565-5600

4576 Miller Rd
Flint, MI 48507
Phone (810) 732-4100

1736 W Michigan Ave
Jackson, MI 49202
Phone (517) 789-7131

30981 5 Mile Rd
Livonia, MI 48154
Phone (734) 522-3000

2875 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 852-5230

32987 Woodward Ave
Royal Oak, MI 48073
Phone (248) 549-9080

21304 Eureka Rd
Taylor, MI 48180
Phone (734) 287-4300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1902377765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23728 CHERRY HILL ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241418",
            "telephone_number": "914-588-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 EUREKA RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806039",
            "telephone_number": "734-374-8500",
            "fax_number": "734-374-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "RUDYNA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.