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

Q: 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.

Q: What is Niraj Nathan's specialty?

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

Q: 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.

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: November 01, 2026.

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

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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

Phone(678) 381-2020

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

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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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Niraj Nathan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The University Of Texas Southwestern Medical Center At Dallas

665 mi

Physical Medicine & Rehabilitation

1000 S BECKHAM AVE
Tyler, TX 75701

Reassigned Medicare billing, Texas enrollment
5,299 clinicians in this Medicare group

NPI 1417099599 (214) 645-0624

Baylor College Of Medicine

734 mi

Family Medicine

1504 TAUB LOOP
Houston, TX 77030

Reassigned Medicare billing, Texas enrollment
2,296 clinicians in this Medicare group

NPI 1053352914 (713) 873-2000

Baylor College Of Medicine

734 mi

Medical Genetics, Ph.D. Medical Genetics

7200 CAMBRIDGE ST FL 10
Houston, TX 77030

Reassigned Medicare billing, Texas enrollment
2,554 clinicians in this Medicare group

NPI 1881026664 (713) 798-0000

Texas Children's Physician Group

734 mi

Pediatrics

6621 FANNIN ST
Houston, TX 77030

Reassigned Medicare billing, Texas enrollment
Medicare enrollment name: Texas Childrens Physician Group
2,498 clinicians in this Medicare group

NPI 1861675506 (832) 824-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

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.

88 services62 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.

65 services42 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.

58 services58 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.

46 services46 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.

32 services22 patients

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye 66991

This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.

19 services13 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

Quality

100

Promoting Interoperability

Improvement Activities

Cost

29.42

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.

MANUEL JOHN CHAKNIS

Ophthalmology

1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519

Gwinnett County (678) 381-2020

DR. PHILIP STEPHEN GARZA M.D.

Ophthalmology

1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519

Gwinnett County (678) 381-2020

DR. AIMEE AUGUSTA MESENBURG OD

Optometrist

1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519

Gwinnett County (678) 381-2020

DR. DHARA PATEL OD

Optometrist

1995 MALL OF GEORGIA BLVD STE A
BUFORD, GA 30519

Gwinnett County (678) 381-2020

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.

Which organizations bill Medicare for Niraj Nathan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Niraj Nathan reassigns Medicare benefits to 4 organizations: The University Of Texas Southwestern Medical Center At Dallas (Tyler, TX), Baylor College Of Medicine (Houston, TX), Baylor College Of Medicine (Houston, TX) and Texas Children's Physician Group (Houston, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Niraj Nathan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.