Individual provider Active NPI

Pranay Gupta, MD

  • Ophthalmology Physician
  • Colonial Heights, VA
National Provider Identifier
1982641049
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101230970 Issued in VA
Practice address
3660 Boulevard
Colonial Heights, VA 23834-1345
Phone
(804) 243-2020
Fax
(804) 754-1428
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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 0101230970 VA Primary

Addresses

Primary practice location

3660 Boulevard
Colonial Heights, VA 23834-1345

Mailing address

809 Club Ridge CT
Chester, VA 23836-2745
Phone (804) 243-2020

Other identifiers 1

IdentifierTypeStateIssuer
6304559MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20041012000152 VA Practitioner - Ophthalmology 1355301789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Maryland School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3660 Boulevard
Colonial Heights, VA 23834-1345
Phone (804) 243-2020

Hospital & facility affiliations

  • John Randolph Medical Center Hospital, Hopewell, VA, CCN 490020

Merit-based Incentive Payment System (MIPS)

Final score
23.29 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
57.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Eye Specialists PC Ophthalmology CurrentSince Jul 1, 2001 Accepting new patients
Carl D. Outen, MD, PC Ophthalmology PastSince Nov 30, 2010 Accepting new patients
Tri Cities Counseling Services LLC Past Accepting new patients
Eye Care Center of Virginia PC PastSince Jul 1, 2019 Accepting new patients

Locations

3660 Boulevard
Colonial Heights, VA 23834
Phone (804) 243-2020

3660 Boulevard
Ste K
Colonial Hgts, VA 23834

203 Sharp St
Lawrenceville, VA 23868
Phone (434) 336-1222

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1982641049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 CLUB RIDGE CT",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238362745",
            "telephone_number": "804-243-2020",
            "fax_number": "804-754-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341345",
            "telephone_number": "804-243-2020",
            "fax_number": "804-754-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRANAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101230970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6304559",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.