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DR. RAJ KAMAL GOYAL M.D., M.P.H.
NPI 1699768721
Ophthalmology in Bedford Park, IL

Active since August 24, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
7456 S STATE RD STE 302, BEDFORD PARK, IL 60638(773) 873-0052(773) 873-0054 Get Directions Write a Review

NPPES record last updated: December 16, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 16, 2021, Jun 30, 2020 (2 updates tracked since 2020).

About Dr. Raj Kamal Goyal M.d., M.p.h. NPPES

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

DR. RAJ KAMAL GOYAL M.D., M.P.H. (NPI 1699768721) is an individual ophthalmology provider in Bedford Park, Illinois, licensed in Illinois (036106534) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of George Washington University School Of Medicine (1993).

NPPES Registry Identity

NPI1699768721
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. RAJ KAMAL GOYALCredential: M.D., M.P.H.
Location Address7456 S STATE RD STE 302Bedford Park, IL 60638-6625
Mailing Address7456 S State Rd Ste 302Bedford Park, IL 60638-6625 · (773) 873-0052 · Fax (773) 873-0054
Phone(773) 873-0052
Fax(773) 873-0054
Sole ProprietorYes
Medical School CMSGeorge Washington University School Of MedicineGraduated 1993
Enumeration DateAugust 24, 2005
Last NPPES UpdateDecember 16, 20212 updates tracked since enumeration
NPPES CertifiedDecember 16, 2021
✔ NPI 1699768721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in IL · 036106534
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.
7456 S STATE RD STE 302, Bedford Park, IL 60638
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Other Identifiers 1

Medicaid036106534IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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. Raj Kamal Goyal M.d., M.p.h. 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 ID5092811448
PECOS Enrollment IDI20070502000279
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 15

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 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.
761 services402 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.
448 services217 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.
415 services367 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.
289 services249 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.
258 services189 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.
178 services176 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60638 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

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
93%568 patients4/55-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.
100%457 patients5/55-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.
66%162 patients3/55-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
84%783 patients1/55-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

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

DR. REEHAM TINEH OD
Optometrist
7456 S STATE RD STE 302
BEDFORD PARK, IL 60638
Cook County (773) 873-0052

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 Raj Goyal's NPI number?

The NPI number for Raj Goyal is 1699768721. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Raj Goyal located?

Raj Goyal practices at 7456 S State Rd Ste 302, Bedford Park, IL 60638. The listed phone number is (773) 873-0052.

What is Raj Goyal's specialty?

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

Is Raj Goyal enrolled in Medicare?

Yes. Raj Goyal 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 Raj Goyal accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Raj Goyal 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 Raj Goyal was last updated on December 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.