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PRIYA GUPTA MD
NPI 1295228278
Ophthalmology in Boston, MA

Active since June 13, 2018PECOS EnrolledAccepts Medicare Assignment
243 CHARLES ST, BOSTON, MA 02114(617) 573-6917 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Priya Gupta Md NPPES

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

PRIYA GUPTA MD (NPI 1295228278) is an individual ophthalmology provider in Boston, Massachusetts, licensed in Massachusetts (291668) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS, is affiliated with Brigham And Women's Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1295228278
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NamePRIYA GUPTACredential: MD
Location Address243 CHARLES STBoston, MA 02114-3096
Mailing Address243 Charles StBoston, MA 02114-3096 · (617) 573-6917
Phone(617) 573-6917
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJune 13, 2018
Last NPPES UpdateJune 29, 2022
NPPES CertifiedJune 29, 2022
✔ NPI 1295228278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MA · 291668
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
243 CHARLES ST, Boston, MA 02114
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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

Priya Gupta 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 ID4385994326
PECOS Enrollment IDI20230727000633
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 8

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.

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.
127 services84 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.
101 services88 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.
53 services24 patients
Microfluid analysis of tears 83861
Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.
46 services23 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
42 services35 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
26 services15 patients

Hospital Affiliations CMS Care Compare

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

Brigham And Women's Hospital

Acute Care Hospitals · Boston, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220110
Location75 Francis StreetBoston, MA 02115 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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.

Other Providers at the Same Location NPPES 20

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

CARLA PETERSEN AU.D., CCC-A
Audiologist
243 CHARLES ST, AUDIOLOGY DEPARTMENT
BOSTON, MA 02114
Suffolk County (617) 573-3266
DR. RYAN CARLSON MD PHD
Student in an Organized Health Care Education/Training Program
243 CHARLES ST
BOSTON, MA 02114
Suffolk County (617) 523-7900
MASSACHUSETTS EYE AND EAR INFIRMARY
Eyewear Supplier
243 CHARLES ST
BOSTON, MA 02114
Suffolk County (617) 573-3182
DANIEL ROBERT LEFEBVRE M.D.
Ophthalmology
243 CHARLES ST, 10TH FLOOR -- OPHTHALMIC PLASTIC SURGERY
BOSTON, MA 02114
Suffolk County (617) 523-7900
ELLIOTT D. KOZIN MD
Otolaryngology
243 CHARLES ST
BOSTON, MA 02114
Suffolk County (617) 573-6545
DR. LUCIA K SOMBERG MD, MPH
Emergency Medicine
243 CHARLES ST
BOSTON, MA 02114
Suffolk County (617) 573-3431
MS. JANET ENGLISH HUETTIG LICSW
Social Worker (Clinical)
243 CHARLES ST
BOSTON, MA 02114
Suffolk County (617) 573-3548
KYUNG OH DO, MS
Anesthesiology
243 CHARLES ST
BOSTON, MA 02114
Suffolk County (617) 573-3380

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 Priya Gupta's NPI number?

The NPI number for Priya Gupta is 1295228278. It was assigned to this individual provider in the NPPES registry on June 13, 2018.

Where is Priya Gupta located?

Priya Gupta practices at 243 Charles St, Boston, MA 02114. The listed phone number is (617) 573-6917.

What is Priya Gupta's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Priya Gupta enrolled in Medicare?

Yes. Priya Gupta 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 Priya Gupta accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Priya Gupta 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.

Is Priya Gupta affiliated with any hospitals?

According to CMS data, Priya Gupta is affiliated with Brigham And Women's Hospital.

When was this NPI record last updated?

The NPPES record for Priya Gupta was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.