Individual provider Active NPI

Ravali Gummi, MD

  • Ophthalmology Physician
  • Kansas City, MO
National Provider Identifier
1033615299
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
93168 Issued in GA
Practice address
2301 Holmes St
Kansas City, MO 64108-2677
Phone
(816) 404-1000
NPI assigned
Apr 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X 93168 GA Primary

Addresses

Primary practice location

2301 Holmes St
Kansas City, MO 64108-2677

Mailing address

2301 Holmes St
Kansas City, MO 64108-2677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221109002114 GA Practitioner - Ophthalmology 5597013334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Eye Clinic, PAGroup PAC ID 0143210427, 39 clinicians

Practice addresses (Care Compare)

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8935
Phone (770) 427-8111

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery170

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Eye Clinic, PA Ophthalmology CurrentSince Aug 30, 2022 Accepting new patients
Marietta Eye Clinic PA Ophthalmology Current Accepting new patients
Marietta Eye Clinic PA CurrentSince Aug 30, 2022 Accepting new patients
Marietta Eye Clinic, PA Past Accepting new patients
Marietta Eye Clinic, PA Ophthalmology Past Accepting new patients

Locations

4450 Calibre Xing NW
Ste 1104
Acworth, GA 30101
Phone (678) 279-1141

100 Old Ball Ground Hwy
#A
Canton, GA 30114

100 Old Ball Ground Hwy
Canton, GA 30114
Phone (770) 479-2195

2860 Ronald Reagan Blvd
Ste 210
Cumming, GA 30041

8841 Hospital Dr
Douglasville, GA 30134
Phone (770) 577-2200

47 Highland Pavilion Ct
Ste 101
Hiram, GA 30141

895 Canton Rd NE
Bldg 200
Marietta, GA 30060
Phone (678) 784-0203

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

2520 Windy Hill Rd SE
Ste 206
Marietta, GA 30067
Phone (770) 952-6851

2453 Powder Springs Rd SW
Ste 400
Marietta, GA 30064
Phone (770) 801-0700

895 Canton Rd NE
Bldg 100
Marietta, GA 30060
Phone (770) 425-6167

10485 Alpharetta St
Roswell, GA 30075
Phone (678) 439-2443

2990 Eagle Dr
Ste 110
Woodstock, GA 30189
Phone (678) 460-4810

Interoperability endpoints

  • Direct secure messaging: rgummi@mariettaeyeclinic.emadirect.md

Organizations & group practices 5

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 1

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1033615299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082677",
            "telephone_number": "816-404-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMMI",
        "first_name": "RAVALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "93168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.