Individual provider Active NPI

Daman Toor Gupta, O.D.

  • Optometrist
  • Dearborn, MI
National Provider Identifier
1962718288
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005017 Issued in MI
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

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 3 clinicians

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 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005017MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Retina Center, PC Optometrist CurrentSince May 6, 2021 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

Verify at the official NPI Registry.