Individual provider Active NPI

Tejaswini Matsyaraja, MD

  • Ophthalmology Physician
  • Lexington, KY
National Provider Identifier
1710786454
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
FL085 Issued in KY
Practice address
110 Conn Ter Ste 550
Lexington, KY 40508-3206
Phone
(859) 323-5867
Fax
(859) 323-8510
NPI assigned
Mar 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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 FL085 KY Primary

Addresses

Primary practice location

110 Conn Ter Ste 550
Lexington, KY 40508-3206

Mailing address

25058 Lind CT
Aldie, VA 20105-6104
Phone (804) 610-4498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250717003371 KY Practitioner - Ophthalmology 0143736157 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FL085KYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Ophthalmology CurrentSince Jul 1, 2025 Accepting new patients
University of Kentucky CurrentSince Jul 1, 2025 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1710786454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25058 LIND CT",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201056104",
            "telephone_number": "804-610-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CONN TER STE 550",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083206",
            "telephone_number": "859-323-5867",
            "fax_number": "859-323-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSYARAJA",
        "first_name": "TEJASWINI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "FL085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.