Subba R Gollamudi, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD0000021892 Issued in TN

Practice address

825 Ridge Lake Blvd
Memphis, TN 38120-9411

Phone

(901) 685-2200

Fax

(901) 820-2342

NPI assigned

May 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN, MS, AR3 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 3

Specialty

Ophthalmology

Education

Yale University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VRF Eye Specialty Group, PLCGroup PAC ID 2264328723, 16 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.7 of 100Reported as group

Quality

86.03

Improvement activities

40

Cost

74.63

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drgollamudi@esg.emadirect.md

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.

• VRF Eye Specialty Group, PLC

  • Ophthalmology Physician
  • Memphis, TN
  • NPI 1699729806

  AR, MS

  Medicare reassignment Care Compare group NPD Authorized official
• Eye Care Surgery Center of Memphis, LLC

  • Ambulatory Surgical Clinic/Center
  • Memphis, TN
  • NPI 1396828323
  NPD Authorized official
• Eye Care Surgery Center of Olive Branch,LLC

  • Ambulatory Surgical Clinic/Center
  • Olive Branch, MS
  • NPI 1720161771
  NPD Authorized official
• Eye Care Surgery Center of Southaven,LLC

  • Ambulatory Surgical Clinic/Center
  • Southaven, MS
  • NPI 1780767673
  NPD Authorized official
• VRF Eye Specialty Group, PLC

  • Optometrist
  • Hernando, MS
  • NPI 1255954863

  Ophthalmology

  NPD

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1154378735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22510",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392252510",
            "telephone_number": "901-685-2200",
            "fax_number": "901-255-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209411",
            "telephone_number": "901-685-2200",
            "fax_number": "901-820-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLAMUDI",
        "first_name": "SUBBA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "E-3527",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "16734",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD0000021892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121686001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3067983",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119845",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "180018881",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "180042504",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David B Goldstein, PH.D.
• Jay P Goldstein, O.D.
• Robert R Goldwin, DDS
• Christopher Golembeski, MD
• Dipti Shah Gollamudi, PHARMD
• April Gollihugh, MS,RD,LDN
• Katellen Gomes, MD
• Isabel Garralon Gomez, M.D.
• Sejal Atta Gondal, MD
• Suchal Atta Gondal

• Ophthalmology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Ophthalmology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.