DR. RAUL GUEVARA M.D.
NPI 1194861054
Ophthalmology - Neuro-ophthalmology in Merrillville, IN

Q: What is Raul Guevara's NPI number?

The NPI number for Raul Guevara is 1194861054. It was assigned to this individual provider in the NPPES registry on January 29, 2007.

Q: What is Raul Guevara's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Neuro-ophthalmology, with taxonomy code 207WX0109X.

Q: When was this NPI record last updated?

The NPPES record for Raul Guevara was last updated on April 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since January 29, 2007PECOS EnrolledAccepts Medicare Assignment

70.04/100

CMS Quality Rating

521 E 86TH AVE STE Z, MERRILLVILLE, IN 46410(219) 769-0777(219) 755-0608 Get Directions Write a Review

NPPES record last updated: April 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 10, 2024, Apr 26, 2018, Oct 24, 2016 (3 updates tracked since 2016).

On this page

About Dr. Raul Guevara M.d. NPPES

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

DR. RAUL GUEVARA M.D. (NPI 1194861054) is an individual neuro-ophthalmology provider in Merrillville, Indiana, licensed in Indiana (01079609A) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Inc, and maintains a secondary practice location in Irving.

NPPES Registry Identity

NPI1194861054

Entity TypeIndividualMale

Primary Taxonomy207WX0109X

Provider Legal NameDR. RAUL GUEVARACredential: M.D.

Location Address521 E 86TH AVE STE ZMerrillville, IN 46410-6236

Mailing Address521 E 86th Ave Ste ZMerrillville, IN 46410-6236 · (219) 769-0777 · Fax (219) 755-0608

Phone(219) 769-0777

Fax(219) 755-0608

Sole ProprietorNo

Medical School CMSOtherGraduated 1990

Enumeration DateJanuary 29, 2007

Last NPPES UpdateApril 10, 20243 updates tracked since enumeration

NPPES CertifiedApril 10, 2024

✔ NPI 1194861054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Neuro-ophthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207WX0109X

License✔ Licensed in IN · 01079609A

Definition

A neuro-ophthalmologist is a subspecialist of ophthalmology. This physician evaluates, treats, and studies disorders of the eye, orbit and nervous system having to do with interactions of the visual motor and visual sensory systems with the central nervous system. Neuro-ophthalmologists manage patients with complex and severe neuro-ophthalmological disorders.

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 01079609A (IN), L5352 (TX)

521 E 86TH AVE STE Z, Merrillville, IN 46410

Open in Google Maps ↗

Secondary Practice Location 1

Location 11215 KINWEST PKWY, STE 120IRVING, TX 75063-3403 · Phone (214) 496-0500 · Fax (214) 496-0922

Other Identifiers 1

OtherIN3021011IN · Medicare Id

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Dr. Raul Guevara M.d. 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 ID8527006352

PECOS Enrollment IDI20180119001305

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 7

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

161 services106 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

131 services77 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

87 services56 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

85 services85 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

73 services73 patients

Exam to measure eye deviation and range of motion 92060

This is an eye exam that checks for any misalignment in your eyes, also known as deviation. It also assesses the movement range of your eyes. The procedure is painless and helps in detecting conditions like strabismus or other vision issues.

65 services61 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150002

Location600 Grant StGary, IN 46402 · Lake County

Emergency services Birthing friendly

Community Hospital

Acute Care Hospitals · Munster, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150125

Location901 Macarthur BlvdMunster, IN 46321 · Lake County

Emergency services Birthing friendly

Franciscan Health Crown Point

Acute Care Hospitals · Crown Point, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number150126

Location12750 Saint Francis DriveCrown Point, IN 46307 · Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46410 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

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.

70.04/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

80.66

Improvement Activities

Cost

25.91

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER A. PALLONE D.O.

Psychiatry & Neurology (Psychiatry)