NPIMap

Individual provider Active NPI

Gautam Mishra, MD

  • Ophthalmology Physician
  • Harrisburg, PA
National Provider Identifier
1295723385
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D61733 Issued in MD
Practice address
10 Capital Drive
Suite 300
Harrisburg, PA 17110
Phone
(717) 233-3937
Fax
(717) 233-5715
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D61733 MD Primary

Addresses

Primary practice location

10 Capital Drive
Suite 300
Harrisburg, PA 17110

Mailing address

10 Capital Drive
Suite 300
Harrisburg, PA 17110
Phone (717) 233-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060814000026 PA Practitioner - Ophthalmology 5698754984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Jefferson Medical College of Thomas Jefferson University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vistaura Eye PCGroup PAC ID 6305828971, 3 clinicians

Practice addresses (Care Compare)

10 Capital Dr
Suite 300
Harrisburg, PA 17110-9412
Phone (717) 233-4124

Hospital & facility affiliations

  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

Merit-based Incentive Payment System (MIPS)

Final score
88.69 of 100Reported as group
Quality
88.33
Improvement activities
40
Cost
77.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D61733MDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vistaura Eye PC Ophthalmology CurrentSince Aug 15, 2006 Accepting new patients
Capital Surgery and Laser Center, LLC PastSince Sep 1, 2012 Accepting new patients
Washington National Eye Center Ophthalmology Past Accepting new patients
Susquehanna Optical Inc PastSince Oct 1, 2012 Accepting new patients
Cornea Consultants of Albany,PLLC Ophthalmology Past Accepting new patients

Locations

10 Capital Dr
Ste 300
Harrisburg, PA 17110
Phone (717) 233-3937

Interoperability endpoints

  • Direct secure messaging: gm@seme.ecldirect.net

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 8

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1295723385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CAPITAL DRIVE",
            "address_2": "SUITE 300",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17110",
            "telephone_number": "717-233-3937",
            "fax_number": "717-233-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CAPITAL DRIVE",
            "address_2": "SUITE 300",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17110",
            "telephone_number": "717-233-3937",
            "fax_number": "717-233-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "GAUTAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D61733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.