Individual provider Active NPI

Gowtham Jonna, M.D.

  • Ophthalmology Physician
  • Austin, TX
National Provider Identifier
1245529767
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
R1552 Issued in TN
Practice address
3705 Medical Pkwy Ste 460
Austin, TX 78705-1024
Phone
(512) 454-5851
Fax
(512) 454-5853
NPI assigned
Apr 5, 2011
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Ophthalmology Physician 207W00000X R1552 TN Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X R1552 TX

Addresses

Primary practice location

3705 Medical Pkwy Ste 460
Austin, TX 78705-1024

Mailing address

3705 Medical Pkwy Ste 460
Austin, TX 78705-1024
Phone (512) 454-5851

Other practice location 1

2311 Pierce Ave
Nashville, TN 37232-0025
Phone (615) 936-2020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gjonna@eretina.intellechartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170712000273 TX Practitioner - Ophthalmology 9537471032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Consultants of Austin PAGroup PAC ID 9830198555, 3 clinicians

Practice addresses (Care Compare)

1880 Round Rock Ave
Suite 300
Round Rock, TX 78681-4085
Phone (512) 454-5851

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1552TNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Consultants of Austin, PA Ophthalmology CurrentSince Aug 1, 2017 Accepting new patients
Brian B. Berger Current Accepting new patients
Vanderbilt University Medical Center Past Accepting new patients
Glaucoma Institute of Austin PA Ophthalmology PastSince Aug 1, 2017 Accepting new patients

Locations

3705 Medical Pkwy
Ste 410
Austin, TX 78705
Phone (512) 320-5779

3705 Medical Pkwy
Ste 460
Austin, TX 78705
Phone (512) 454-5851

1880 Round Rock Ave
Ste 300
Round Rock, TX 78681
Phone (512) 454-5851

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.

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1245529767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY STE 460",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051024",
            "telephone_number": "512-454-5851",
            "fax_number": "512-454-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY STE 460",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051024",
            "telephone_number": "512-454-5851",
            "fax_number": "512-454-5853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2311 Pierce Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320025",
            "country_code": "US",
            "telephone_number": "615-936-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONNA",
        "first_name": "GOWTHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-05",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "R1552",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "R1552",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjonna@eretina.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "3705 Medical Pkwy Ste 410",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787051023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.