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RUMYA RAO MD
NPI 1073657474
Ophthalmology - Retina Specialist in Niles, IL

Active since February 18, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
8780 W. GOLF ROAD #304, NILES, IL 60714(847) 297-8900 Get Directions Write a Review

NPPES record last updated: August 2, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 2, 2019, Jun 22, 2017 (2 updates tracked since 2017).

About Rumya Rao Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUMYA RAO MD (NPI 1073657474) is an individual retina specialist in Niles, Illinois, licensed in Illinois (036128385) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Crystal Lake, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1073657474
Entity TypeIndividualFemale
Primary Taxonomy207WX0107X
Provider Legal NameRUMYA RAOCredential: MD
Location Address8780 W. GOLF ROAD #304Niles, IL 60714
Mailing Address8780 W. Golf Road #304Niles, IL 60714 · (847) 297-8900
Phone(847) 297-8900
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateFebruary 18, 2007
Last NPPES UpdateAugust 2, 20192 updates tracked since enumeration
✔ NPI 1073657474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License✔ Licensed in IL · 036128385
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License ME107363 (FL)

Secondary Practice Location 1

Location 1820 E Terra Cotta Ave Ste 247Crystal Lake, IL 60014-3655 · Phone (815) 788-1000 · Fax (815) 788-2790

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Rumya Rao Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587857321
PECOS Enrollment IDI20110912000493
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
22,980 services91 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,700 services771 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
1,504 services675 patients
Extended exam of the back part of the eye with retinal drawing 92201
This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.
1,138 services598 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
946 services160 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
863 services263 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60714 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%88 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rumya Rao's NPI number?

The NPI number for Rumya Rao is 1073657474. It was assigned to this individual provider in the NPPES registry on February 18, 2007.

Where is Rumya Rao located?

Rumya Rao practices at 8780 W. Golf Road #304, Niles, IL 60714. The listed phone number is (847) 297-8900.

What is Rumya Rao's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Rumya Rao enrolled in Medicare?

Yes. Rumya Rao is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Rumya Rao accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and UnitedHealthcare list Rumya Rao as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rumya Rao was last updated on August 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.