Active NPI
Praveen Jeyaseelan, MD
- Neuro-ophthalmology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuro-ophthalmology Physician
- License
- ME148721
- Practice address
- 333 E Ontario St Apt 3309B
Chicago, IL 60611-8401 - Phone
- (443) 962-5153
- NPI assigned
- Aug 2, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuro-ophthalmology Physician | 207WX0109X | ME148721 | FL | Primary |
Addresses
Primary practice location
333 E Ontario St Apt 3309B
Chicago, IL 60611-8401
Mailing address
333 E Ontario St Apt 3309B
Chicago, IL 60611-8401
Phone (443) 962-5153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 598-4865
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 16 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1018 | WV | MD | Professional Counselor |
| ME148721 | FL | MD | Neuro-ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Virginia University Medical Corporation | Current | Accepting new patients | |
| Health and Education Building | Current | Accepting new patients | |
| West Virginia University Medical Corporation | Current | Accepting new patients |
Locations
16 Sterling Dr
Ste 102
Bridgeport, WV 26330
Phone (681) 342-2133
1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500
Interoperability endpoints
- pjeyaseelan265761@direct.wvuhsdirect.com
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Morgantown, WV
- NPI 1275504508
-
- Student Health Clinic/Center
- Morgantown, WV
- NPI 1174803027
-
- Community/Behavioral Health Agency
- Martinsburg, WV
- NPI 1174233530
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Morgantown, WV
- NPI 1841271459
-
- General Acute Care Hospital
- Wheeling, WV
- NPI 1104821305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619568000000",
"number": "1619522067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E ONTARIO ST APT 3309B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606118401",
"telephone_number": "443-962-5153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E ONTARIO ST APT 3309B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606118401",
"telephone_number": "443-962-5153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEYASEELAN",
"first_name": "PRAVEEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-02",
"last_updated": "2021-04-28",
"certification_date": "2021-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207WX0109X",
"taxonomy_group": "",
"desc": "Ophthalmology, Neuro-ophthalmology",
"state": "FL",
"license": "ME148721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.