Organization Active NPI

International Eye Associates P.a.

  • Ophthalmology Physician
  • Ormond Beach, FL
National Provider Identifier
1972524023
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0047655 Issued in FL
Legal business name
INTERNATIONAL EYE ASSOCIATES P.A.
Practice address
1545 Hand Avenue
Suite B3
Ormond Beach, FL 32174-1140
Phone
(386) 673-3939
Fax
(386) 677-5374
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Authorized official

Name
Dr. Mark S. Rubin, M.D.
Title
Doctor/Owner
Phone
(386) 673-3939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X ME0047655 FL Primary

Addresses

Primary practice location

1545 Hand Avenue
Suite B3
Ormond Beach, FL 32174-1140

Mailing address

1545 Hand Avenue
Suite B3
Ormond Beach, FL 32174-1140
Phone (386) 673-3939

Other identifiers 1

IdentifierTypeStateIssuer
052266000MedicaidFL

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
10D1038488International Eye Associates PA1545 Hand Ave Ste B3, Ormond Beach, FL 32174Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Locations

550 Memorial Cir
Ste N
Ormond Beach, FL 32174
Phone (386) 615-8909

Practitioners & affiliated clinicians

Practitioners 2

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1972524023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 HAND AVENUE",
            "address_2": "SUITE B3",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741140",
            "telephone_number": "386-673-3939",
            "fax_number": "386-677-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 HAND AVENUE",
            "address_2": "SUITE B3",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741140",
            "telephone_number": "386-673-3939",
            "fax_number": "386-677-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL EYE ASSOCIATES P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "386-673-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0047655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052266000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.