Individual provider Active NPI

Raghav Raj Gupta, M.D.

  • Ophthalmology Physician
  • Lewisville, TX
National Provider Identifier
1326084146
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
L2293 Issued in TX
Practice address
1850 Lakepointe Drive
Suite 200
Lewisville, TX 75057-6443
Phone
(972) 436-5040
Fax
(972) 221-0249
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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 L2293 TX Primary

Addresses

Primary practice location

1850 Lakepointe Drive
Suite 200
Lewisville, TX 75057-6443

Mailing address

1850 Lakepointe Drive
Suite 200
Lewisville, TX 75057-6443
Phone (972) 436-5040

Other identifiers 3

IdentifierTypeStateIssuer
0073JFOtherTXBCBS
8G6860OtherTXBCBS
158173801MedicaidTX

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
I20041029000878 TX Practitioner - Ophthalmology 8426032657 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L2293TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WSK Eye Associates PA Ophthalmology CurrentSince Jul 1, 2013 Accepting new patients
Eye Surgery of Texas, P.a. Ophthalmology Past Accepting new patients
Harvey L Carter III MD PA Ophthalmology PastSince Jan 19, 1994 Accepting new patients
Vista Ophthalmology Associates, PA Ophthalmology PastSince Jan 20, 2003 Accepting new patients
Carter Optical Inc Past Accepting new patients

Locations

5575 Warren Pkwy
Ste 210
Frisco, TX 75034
Phone (214) 618-3937

1850 Lakepointe Dr
Ste 200
Lewisville, TX 75057
Phone (972) 436-5040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1326084146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 LAKEPOINTE DRIVE",
            "address_2": "SUITE 200",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576443",
            "telephone_number": "972-436-5040",
            "fax_number": "972-221-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 LAKEPOINTE DRIVE",
            "address_2": "SUITE 200",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576443",
            "telephone_number": "972-436-5040",
            "fax_number": "972-221-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RAGHAV",
        "middle_name": "RAJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "L2293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0073JF",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8G6860",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158173801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.