Individual provider Active NPI

Kajal Dhebaria, O.D.

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1609126341
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2272 Issued in NC
Practice address
8511 Colonnade Center Dr Ste 100
Raleigh, NC 27615-5846
Phone
(919) 977-0303
Fax
(919) 977-0410
NPI assigned
Sep 10, 2012
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2272 NC Primary
Corneal and Contact Management Optometrist 152WC0802X 2272 NC
Pediatric Optometrist 152WP0200X 2272 NC
Occupational Vision Optometrist 152WX0102X 2272 NC

Addresses

Primary practice location

8511 Colonnade Center Dr Ste 100
Raleigh, NC 27615-5846

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121112000526 NC Practitioner - Optometry 7911156732 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knightdale Eyecare Optometric, P.a.Group PAC ID 2769577733, 3 clinicians
Good Looks OD PAGroup PAC ID 1658515465, 3 clinicians

Practice addresses (Care Compare)

742 McKnight Dr
Suite 100
Knightdale, NC 27545-7764
Phone (919) 266-2048

8511 Colonnade Ctr Dr
Suite 100
Raleigh, NC 27615-5846
Phone (919) 977-0303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2272NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Institute OD Optometrist CurrentSince Mar 17, 2018 Accepting new patients
Knightdale Eyecare Optometric, P.a. Optometrist CurrentSince Mar 19, 2018 Accepting new patients
Good Looks, OD, PA Optometrist CurrentSince Mar 19, 2018 Accepting new patients
Blue Ridge Day Surgery Center, LP PastSince Sep 29, 2012 Accepting new patients
Tei-Wake Forest OD PLLC Optometrist Past Accepting new patients

Locations

742 McKnight Dr
Ste 100
Knightdale, NC 27545
Phone (919) 266-2048

111 Seaboard Ave
Raleigh, NC 27604

111 Seaboard Ave
Ste 110
Raleigh, NC 27604
Phone (919) 200-4840

712 Seaboard Station Dr
Raleigh, NC 27604
Phone (919) 200-4840

8511 Colonnade Center Dr
Raleigh, NC 27615

8511 Colonnade Center Dr
Ste 100
Raleigh, NC 27615
Phone (910) 527-9517

3211 Rogers Rd
Ste 100
Wake Forest, NC 27587
Phone (919) 453-1220

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": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1609126341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 COLONNADE CENTER DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155846",
            "telephone_number": "919-977-0303",
            "fax_number": "919-977-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHEBARIA",
        "first_name": "KAJAL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2272",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "2272",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NC",
            "license": "2272",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NC",
            "license": "2272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.