DR. PAUL VARASTAD RAPHAELIAN MD
NPI 1164450201
Ophthalmology - Retina Specialist in Norton Shores, MI

Q: What is Paul Raphaelian's NPI number?

The NPI number for Paul Raphaelian is 1164450201. It was assigned to this individual provider in the NPPES registry on June 29, 2006.

Q: What is Paul Raphaelian's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Q: When was this NPI record last updated?

The NPPES record for Paul Raphaelian was last updated on January 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 29, 2006PECOS EnrolledAccepts Medicare Assignment

95.6/100

CMS Quality Rating

5957 HARVEY ST, 100, NORTON SHORES, MI 49444(231) 733-7832(231) 733-2666 Get Directions Write a Review

NPPES record last updated: January 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 26, 2022, Aug 4, 2020, Jan 8, 2018 and 1 more (4 updates tracked since 2017).

On this page

About Dr. Paul Varastad Raphaelian Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAUL VARASTAD RAPHAELIAN MD (NPI 1164450201) is an individual retina specialist in Norton Shores, Michigan, licensed in Michigan (4301066043) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Trinity Health Muskegon Hospital, and is a graduate of Rush Medical College Of Rush University (1989).

NPPES Registry Identity

NPI1164450201

Entity TypeIndividualMale

Primary Taxonomy207WX0107X

Provider Legal NameDR. PAUL VARASTAD RAPHAELIANCredential: MD

Location Address5957 HARVEY ST, 100Norton Shores, MI 49444-9737

Mailing Address39650 Orchard Hill Pl, 200Novi, MI 48375-5331 · (248) 319-0161 · Fax (248) 319-0170

Phone(231) 733-7832

Fax(231) 733-2666

Sole ProprietorNo

Medical School CMSRush Medical College Of Rush UniversityGraduated 1989

Enumeration DateJune 29, 2006

Last NPPES UpdateJanuary 26, 20224 updates tracked since enumeration

NPPES CertifiedJanuary 26, 2022

✔ NPI 1164450201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians

Taxonomy Code207WX0107X

License✔ Licensed in MI · 4301066043

Definition

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Also ListedOphthalmologyTaxonomy 207W00000X · License 4301066043 (MI)

5957 HARVEY ST, Norton Shores, MI 49444

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Paul Varastad Raphaelian Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022920529

PECOS Enrollment IDI20100923000952

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

13,680 services38 patients

Injection, ranibizumab, 0.1 mg J2778

Ranibizumab is a medication given via injection to treat certain eye conditions like age-related macular degeneration. It works by slowing vision loss and in some cases, improving vision by blocking abnormal blood vessel growth in the eye.

1,348 services48 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

1,093 services388 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

1,076 services379 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

786 services70 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

759 services150 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

57 services57 patients

Extended exam of the back part of the eye with optic nerve drawing 92202

This procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.

39 services38 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

32 services31 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

22 services22 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

20 services17 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

15 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Trinity Health Muskegon Hospital

Acute Care Hospitals · Muskegon, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230066

Location1500 E Sherman BlvdMuskegon, MI 49441 · Muskegon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49444 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.6/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

Promoting Interoperability

Improvement Activities

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WEST SHORE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, PLC

Dentist (Oral and Maxillofacial Surgery)

5957 HARVEY ST
NORTON SHORES, MI 49444

Muskegon County (231) 733-1571

ASSOCIATED RETINAL CONSULTANTS, PC

Ophthalmology

5957 HARVEY ST, 100
NORTON SHORES, MI 49444

Muskegon County (231) 733-7832

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Raphaelian's NPI number?

The NPI number for Paul Raphaelian is 1164450201. It was assigned to this individual provider in the NPPES registry on June 29, 2006.

Where is Paul Raphaelian located?

Paul Raphaelian practices at 5957 Harvey St 100, Norton Shores, MI 49444. The listed phone number is (231) 733-7832.

What is Paul Raphaelian's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Paul Raphaelian enrolled in Medicare?

Yes. Paul Raphaelian is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Paul Raphaelian accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Paul Raphaelian as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Paul Raphaelian affiliated with any hospitals?

According to CMS data, Paul Raphaelian is affiliated with Trinity Health Muskegon Hospital.

When was this NPI record last updated?

The NPPES record for Paul Raphaelian was last updated on January 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.