NIRAJ RAMA NATHAN M.D.
NPI 1588920060
Ophthalmology - Glaucoma Specialist in Buford, GA

Active since April 09, 2012PECOS Enrolled
77.57/100
CMS Quality Rating
1995 MALL OF GEORGIA BLVD STE A, BUFORD, GA 30519(678) 381-2020 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 11, 2023, Jun 26, 2016 (2 updates tracked since 2016).

About Niraj Rama Nathan M.d. NPPES

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

NIRAJ RAMA NATHAN M.D. (NPI 1588920060) is an individual glaucoma specialist in Buford, Georgia, licensed in Georgia (94296) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1588920060
Entity TypeIndividualMale
Primary Taxonomy207WX0009X
Provider Legal NameNIRAJ RAMA NATHANCredential: M.D.
Location Address1995 MALL OF GEORGIA BLVD STE ABuford, GA 30519-6622
Mailing Address1300 Peachtree Industrial Blvd Ste 1201Suwanee, GA 30024-4550
Sole ProprietorNo
Enumeration DateApril 9, 2012
Last NPPES UpdateJanuary 11, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2023
NPI 1588920060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Glaucoma SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0009X
License Licensed in GA · 94296
Definition
An ophthalmologist who specializes in the treatment of glaucoma and other disorders related to increased intraocular pressure and optic nerve damage. This specialty involves the medical and surgical treatment of these conditions.
Also ListedOphthalmologyTaxonomy 207W00000X · License 94296 (GA)
1995 MALL OF GEORGIA BLVD STE A, Buford, GA 30519

Secondary Practice Locations 2

Location 111315 Johns Creek Pkwy Ste 300Duluth, GA 30097-2644 · Phone (678) 381-2020
Location 21250 Scenic Hwy Ste 1700Lawrenceville, GA 30045-7823 · Phone (678) 381-2020

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Niraj Rama Nathan M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 12

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.
371 services233 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.
228 services195 patients
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).
214 services213 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.
162 services122 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.
129 services125 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.
110 services109 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30519 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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.

77.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability95
Improvement Activities40
Cost29.42

Other Providers at the Same Location NPPES 4

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

Ophthalmology
1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519
Ophthalmology
1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519
Optometrist
1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519
Optometrist
1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519

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 Niraj Nathan's NPI number?

The NPI number for Niraj Nathan is 1588920060. It was assigned to this individual provider in the NPPES registry on April 9, 2012.

Where is Niraj Nathan located?

Niraj Nathan practices at 1995 Mall Of Georgia Blvd Ste A, Buford, GA 30519. The listed phone number is (678) 381-2020.

What is Niraj Nathan's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Glaucoma Specialist, with taxonomy code 207WX0009X.

Is Niraj Nathan enrolled in Medicare?

Yes. Niraj Nathan is registered in the Medicare PECOS enrollment system.

What insurance does Niraj Nathan accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Niraj Nathan 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 Niraj Nathan was last updated on January 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.