Individual provider Active NPI

Avtar T Ghuman, MD

  • Retina Specialist (Ophthalmology) Physician
  • Fort Myers, FL
National Provider Identifier
1801883822
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
ME80678 Issued in FL
Practice address
6901 International Center Blvd
Ft Myers, FL 33912-7125
Phone
(239) 939-4323
Fax
(239) 939-3983
NPI assigned
Oct 4, 2005
Last updated
Dec 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME0080678 FL
Pediatrics Physician 208000000X ME0080678 FL
Retina Specialist (Ophthalmology) Physician 207WX0107X ME80678 FL Primary

Addresses

Primary practice location

6901 International Center Blvd
Ft Myers, FL 33912-7125

Mailing address

6901 International Center Blvd
Fort Myers, FL 33912-7125
Phone (239) 939-4323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100708000575 FL Practitioner - Ophthalmology 0547285124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Medical Branch at Galveston, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13492 Research Blvd
Suite 120
Austin, TX 78750

6333 N Federal Hwy
Suite 300
Fort Lauderdale, FL 33308-1909

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0080678FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Vitreous Consultants Ophthalmology CurrentSince Oct 1, 2024 Accepting new patients

Locations

950 Glades Rd
Ste 1C
Boca Raton, FL 33431
Phone (305) 294-5504

106 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-4712

6901 International Center Blvd
Fort Myers, FL 33912
Phone (239) 939-4323

6333 N Federal Hwy
Ste 300
Ft Lauderdale, FL 33308
Phone (954) 776-6880

2525 Harbor Blvd
Ste 302
Pt Charlotte, FL 33952
Phone (941) 924-0303

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1801883822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 INTERNATIONAL CENTER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127125",
            "telephone_number": "239-939-4323",
            "fax_number": "239-939-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 INTERNATIONAL CENTER BLVD",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339127125",
            "telephone_number": "239-939-4323",
            "fax_number": "239-939-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHUMAN",
        "first_name": "AVTAR",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0080678",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0080678",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME80678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.