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DR. BHUMI BHUPEN KINARIWALA MD
NPI 1548798143
Ophthalmology in Raleigh, NC

Active since May 25, 2017PECOS EnrolledAccepts Medicare Assignment
70.1/100
CMS Quality Rating
5962 SIX FORKS RD, RALEIGH, NC 27609(919) 876-4064(919) 876-3159 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 14, 2026, May 25, 2017 (2 updates tracked since 2017).

About Dr. Bhumi Bhupen Kinariwala Md NPPES

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

DR. BHUMI BHUPEN KINARIWALA MD (NPI 1548798143) is an individual ophthalmology provider in Raleigh, North Carolina, licensed in North Carolina (2025-03727) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS and is a graduate of Jefferson Medical College Of Thomas Jefferson University (2017).

NPPES Registry Identity

NPI1548798143
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NameDR. BHUMI BHUPEN KINARIWALACredential: MD
Location Address5962 SIX FORKS RDRaleigh, NC 27609-3895
Mailing Address640 Saint Albans Dr Unit 331Raleigh, NC 27609-2277 · (848) 219-2464
Phone(919) 876-4064
Fax(919) 876-3159
Sole ProprietorYes
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2017
Enumeration DateMay 25, 2017
Last NPPES UpdateApril 14, 20262 updates tracked since enumeration
NPPES CertifiedApril 14, 2026
✔ NPI 1548798143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in NC · 2025-03727
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.
5962 SIX FORKS RD, Raleigh, NC 27609
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Accepted Insurance

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

Dr. Bhumi Bhupen Kinariwala 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 ID6406124767
PECOS Enrollment IDI20260223000853
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 5

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 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.
142 services63 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.
127 services43 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.
31 services25 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.
31 services26 patients
Closure of tear duct opening using plug 68761
Closure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.
19 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27609 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

70.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.08
Promoting Interoperability87
Improvement Activities40
Cost27.09

Other Providers at the Same Location NPPES 2

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

NORTH RALEIGH OPHTHALMOLOGY, P.A.
Ophthalmology
5962 SIX FORKS RD
RALEIGH, NC 27609
Wake County (919) 876-4064
ISAAC WILLIAM PORTER M.D.
Ophthalmology
5962 SIX FORKS RD
RALEIGH, NC 27609
Wake County (919) 876-4064

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 Bhumi Kinariwala's NPI number?

The NPI number for Bhumi Kinariwala is 1548798143. It was assigned to this individual provider in the NPPES registry on May 25, 2017.

Where is Bhumi Kinariwala located?

Bhumi Kinariwala practices at 5962 Six Forks Rd, Raleigh, NC 27609. The listed phone number is (919) 876-4064.

What is Bhumi Kinariwala's specialty?

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

Is Bhumi Kinariwala enrolled in Medicare?

Yes. Bhumi Kinariwala 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 Bhumi Kinariwala accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 3 other insurers list Bhumi Kinariwala 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 Bhumi Kinariwala was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.