GAURAV GUPTA M.D.
NPI 1366559114
Ophthalmology in Providence, RI

Q: What is Gaurav Gupta's NPI number?

The NPI number for Gaurav Gupta is 1366559114. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Q: What is Gaurav Gupta's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Gaurav Gupta was last updated on October 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 August 25, 2006PECOS EnrolledAccepts Medicare Assignment

150 E MANNING ST, PROVIDENCE, RI 02906(401) 272-2020(401) 421-5979 Get Directions Write a Review

NPPES record last updated: October 23, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Gaurav Gupta M.d. NPPES

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

GAURAV GUPTA M.D. (NPI 1366559114) is an individual ophthalmology provider in Providence, Rhode Island, licensed in Rhode Island (MD12949) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and is a graduate of University Of Massachusetts Medical School (2002).

NPPES Registry Identity

NPI1366559114

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameGAURAV GUPTACredential: M.D.

Location Address150 E MANNING STProvidence, RI 02906-5109

Mailing Address150 E Manning StProvidence, RI 02906-5109 · (401) 272-2020 · Fax (401) 421-5979

Phone(401) 272-2020

Fax(401) 421-5979

Sole ProprietorNo

Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2002

Enumeration DateAugust 25, 2006

Last NPPES UpdateOctober 23, 2020

NPPES CertifiedOctober 23, 2020

✔ NPI 1366559114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in RI · MD12949

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.

150 E MANNING ST, Providence, RI 02906

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Other Identifiers 2

Other1366559114RI · Npi Number

OtherMD12949RI · Ri Licence Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Providence Health Plan.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

Gaurav Gupta 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 ID1850392697

PECOS Enrollment IDI20091007000739, I20091208000539

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 14

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.

3,060 services14 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.

2,011 services793 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.

1,892 services186 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.

1,169 services227 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.

939 services625 patients

Injection, bevacizumab, 10 mg J9035

Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.

74 services23 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

70 services70 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

69 services41 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

58 services58 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

55 services55 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.

21 services18 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.

17 services17 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

15 services14 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.

14 services11 patients

Hospital Affiliations CMS Care Compare

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

Rhode Island Hospital

Acute Care Hospitals · Providence, RI

3/5 CMS rating

OwnershipTribal

CMS Certification Number410007

Location593 Eddy StreetProvidence, RI 02903 · Providence County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02906 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

$134.17 typical visit price

range $58.57 – $177.03

Typical copayment $33.54 (range $14.64 – $44.25)

Most-billed visit code 99204

Established Patient

$72.93 typical visit price

range $18.92 – $144.38

Typical copayment $18.23 (range $4.73 – $36.09)

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.

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement

Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…

84%585 patients4/55-star benchmark: 100%

Age-Related Macular Degeneration (AMD): Dilated Macular Examination

Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…

78%582 patients3/55-star benchmark: 100%

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%577 patients5/55-star benchmark: 100%

Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…

83%463 patients3/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%591 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

1%181 patients1/55-star benchmark: 100%

Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months

99%168 patients4/55-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.

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Other Providers at the Same Location NPPES 17

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

REFOCUS EYE HEALTH OF RI, LLC

Ophthalmology