Active NPI
Daman Toor Gupta, O.D.
- Optometrist
- Dearborn, MI
National Provider Identifier
1962718288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901005017
- Practice address
- 25230 Michigan Ave
Dearborn, MI 48124-1715 - Phone
- (313) 441-2227
- Fax
- (313) 441-2241
- NPI assigned
- Aug 24, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901005017 | MI | Primary |
Addresses
Primary practice location
25230 Michigan Ave
Dearborn, MI 48124-1715
Mailing address
25230 Michigan Ave
Dearborn, MI 48124-1715
Phone (313) 441-2227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210510002793 | MI | Practitioner - Optometry | 3971892449 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Michigan Retina Center, PC
Practice addresses (Care Compare)
25230 Michigan Ave
Dearborn, MI 48124-1715
Phone (313) 441-2227
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901005017 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Retina Center, PC | Optometrist | Current | Accepting new patients |
Locations
25230 Michigan Ave
Dearborn, MI 48124
Phone (313) 441-2227
5333 McAuley Dr
Rm 1018
Ypsilanti, MI 48197
Phone (313) 441-2227
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701129600000",
"number": "1962718288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25230 MICHIGAN AVE",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481241715",
"telephone_number": "313-441-2227",
"fax_number": "313-441-2241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25230 MICHIGAN AVE",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481241715",
"telephone_number": "313-441-2227",
"fax_number": "313-441-2241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "DAMAN",
"middle_name": "TOOR",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-24",
"last_updated": "2023-11-28",
"certification_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901005017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.