DR. RAJESH KUMAR SHETTY M.D.
NPI 1538159454
Ophthalmology in Jacksonville, FL

Q: What is Rajesh Shetty's NPI number?

The NPI number for Rajesh Shetty is 1538159454. It was assigned to this individual provider in the NPPES registry on October 22, 2005.

Q: What is Rajesh Shetty'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 Rajesh Shetty was last updated on April 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 October 22, 2005PECOS EnrolledAccepts Medicare Assignment

80.44/100

CMS Quality Rating

11512 LAKE MEAD AVENUE, STE 534, JACKSONVILLE, FL 32256(904) 642-2222(904) 518-3297 Get Directions Write a Review

NPPES record last updated: April 19, 2018. Verified against the NPPES registry weekly; last sync: August 30, 2026.

On this page

About Dr. Rajesh Kumar Shetty M.d. NPPES

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

DR. RAJESH KUMAR SHETTY M.D. (NPI 1538159454) is an individual ophthalmology provider in Jacksonville, Florida, licensed in Florida (ME84552) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of Indiana Medical College, School Of Medicine Of Purdue University (1996).

NPPES Registry Identity

NPI1538159454

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. RAJESH KUMAR SHETTYCredential: M.D.

Location Address11512 LAKE MEAD AVENUE, STE 534Jacksonville, FL 32256-5835

Mailing Address11945 San Jose Blvd., Ste 300Jacksonville, FL 32223-1627 · (904) 396-1725 · Fax (904) 399-1717

Phone(904) 642-2222

Fax(904) 518-3297

Sole ProprietorNo

Medical School CMSIndiana Medical College, School Of Medicine Of Purdue UniversityGraduated 1996

Enumeration DateOctober 22, 2005

Last NPPES UpdateApril 19, 2018

✔ NPI 1538159454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in FL · ME84552

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.

Also ListedOphthalmology · Glaucoma SpecialistTaxonomy 207WX0009X · License ME84552 (FL)

11512 LAKE MEAD AVENUE, Jacksonville, FL 32256

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Other Identifiers 3

Other28020FL · Bluecross/blueshield

OtherP01378393FL · Railroad Medicare

Medicaid264845800FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) 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. Rajesh Kumar Shetty 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 ID1658422399

PECOS Enrollment IDI20090619000345

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 20

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 optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

1,099 services903 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.

896 services738 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.

590 services550 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.

351 services321 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.

322 services289 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.

285 services154 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

280 services152 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.

184 services169 patients

Measurement of corneal curvature and depth of eye 92136

167 services166 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

161 services118 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

161 services144 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

128 services128 patients

Laser repair to improve eye fluid flow 65855

Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.

112 services77 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

99 services99 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

91 services87 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.

89 services88 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.

66 services66 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.

55 services55 patients

Insertion of eye fluid drainage device 66183

The insertion of an eye fluid drainage device is a procedure to manage eye pressure. A small device is placed in the eye to help drain excess fluid, reducing pressure that can damage the optic nerve and lead to vision loss. This procedure is often used for glaucoma treatment.

34 services28 patients

Revision or repair of operative wound of eye 66250

A revision or repair of an operative wound of the eye is a procedure to fix complications from a previous eye surgery. It involves addressing issues like infection, healing problems, or incorrect positioning of surgical materials. The goal is to promote proper healing and restore optimal eye function.

16 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32256 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

80.44/100

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

Individually scored

Quality

66.07

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Advance Care Plan

35%627 patients2/55-star benchmark: 100%

Breast Cancer Screening

1%269 patients1/55-star benchmark: 93%

Cervical Cancer Screening

1%95 patients1/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

41%44 patients2/55-star benchmark: 87%

Colorectal Cancer Screening

3%473 patients1/55-star benchmark: 88%

Diabetes: Eye Exam

99%153 patients4/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

100%53 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

100%3,943 patients5/55-star benchmark: 100%

e-Prescribing

87%1,049 patients1/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

1%1,872 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

28%782 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

0%773 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%3,579 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 11% · 1,673 patients

11%1,673 patients

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

3%1,184 patients

Provide Patients Electronic Access to Their Health Information

86%1,019 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

79%110 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 1,920 patients

Patients totalRate: 0% · 1,920 patients

0%1,920 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.

Other Providers at the Same Location NPPES 3

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

DR. ANN GEFEN GRENADIER PHD, LMHC

Counselor (Mental Health)

11512 LAKE MEAD AVENUE, SUITE 703
JACKSONVILLE, FL 32256

Duval County (904) 646-0054

BETTY LOU WATSON LMHC

Counselor (Mental Health)

11512 LAKE MEAD AVENUE, SUITE &03
JACKSONVILLE, FL 32256

Duval County (904) 646-0054

BEVERLY HELGANZ LMHC, CAP

Counselor (Mental Health)

11512 LAKE MEAD AVENUE, SUITE 703
JACKSONVILLE, FL 32256

Duval County (904) 646-0054

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 Rajesh Shetty's NPI number?

The NPI number for Rajesh Shetty is 1538159454. It was assigned to this individual provider in the NPPES registry on October 22, 2005.

Where is Rajesh Shetty located?

Rajesh Shetty practices at 11512 Lake Mead Avenue Ste 534, Jacksonville, FL 32256. The listed phone number is (904) 642-2222.

What is Rajesh Shetty's specialty?

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

Is Rajesh Shetty enrolled in Medicare?

Yes. Rajesh Shetty 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 Rajesh Shetty accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Rajesh Shetty 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 Rajesh Shetty was last updated on April 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.