PRANAY GUPTA MD
NPI 1982641049
Ophthalmology in Colonial Heights, VA

Active since May 31, 2006PECOS EnrolledAccepts Medicare Assignment
42/100
CMS Quality Rating
3660 BOULEVARD, COLONIAL HEIGHTS, VA 23834(804) 243-2020(804) 754-1428 Get Directions Write a Review

NPPES record last updated: April 4, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pranay Gupta Md NPPES

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

PRANAY GUPTA MD (NPI 1982641049) is an individual ophthalmology provider in Colonial Heights, Virginia, licensed in Virginia (0101230970) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with John Randolph Medical Center, and is a graduate of University Of Maryland School Of Medicine (1997).

NPPES Registry Identity

NPI1982641049
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NamePRANAY GUPTACredential: MD
Location Address3660 BOULEVARDColonial Heights, VA 23834-1345
Mailing Address809 Club Ridge CtChester, VA 23836-2745 · (804) 243-2020 · Fax (804) 754-1428
Fax(804) 754-1428
Sole ProprietorNo
Medical School CMSUniversity Of Maryland School Of MedicineGraduated 1997
Enumeration DateMay 31, 2006
Last NPPES UpdateApril 4, 2008
NPI 1982641049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in VA · 0101230970
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.
3660 BOULEVARD, Colonial Heights, VA 23834

Other Identifiers 3

Medicare PIN000001V63VA
Medicare UPINH39147VA
Medicaid6304559VA

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 and accepts Medicare assignment

Pranay Gupta 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 ID1355301789
PECOS Enrollment IDI20041012000152
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 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.
287 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.
264 services130 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.
259 services241 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.
78 services78 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.
42 services31 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.
40 services27 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

John Randolph Medical Center

Acute Care Hospitals · Hopewell, VA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number490020
Location411 West Randolph RoadHopewell, VA 23860 · Hopewell City County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23834 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
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.

42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality30
Improvement Activities0
Cost100

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
100%188 patients5/55-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%1,008 patients5/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
1%122 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 13

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

Internal Medicine (Endocrinology, Diabetes & Metabolism)
3660 BOULEVARD, SUITE G
COLONIAL HEIGHTS, VA 23834
Ophthalmology
3660 BOULEVARD
COLONIAL HEIGHTS, VA 23834
Social Worker (Clinical)
3660 BOULEVARD, SUITE A
COLONIAL HEIGHTS, VA 23834
Internal Medicine (Endocrinology, Diabetes & Metabolism)
3660 BOULEVARD, SUITE G
COLONIAL HEIGHTS, VA 23834
Obstetrics & Gynecology
3660 BOULEVARD, SUITE J
COLONIAL HEIGHTS, VA 23834
Podiatrist
3660 BOULEVARD, STE B
COLONIAL HEIGHTS, VA 23834
Dentist (General Practice)
3660 BOULEVARD, SUITE F
COLONIAL HEIGHTS, VA 23834
Home Health
3660 BOULEVARD, SUITE E
COLONIAL HEIGHTS, VA 23834

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 Pranay Gupta's NPI number?

The NPI number for Pranay Gupta is 1982641049. It was assigned to this individual provider in the NPPES registry on May 31, 2006.

Where is Pranay Gupta located?

Pranay Gupta practices at 3660 Boulevard, Colonial Heights, VA 23834. The listed phone number is (804) 243-2020.

What is Pranay Gupta's specialty?

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

Is Pranay Gupta enrolled in Medicare?

Yes. Pranay Gupta 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 Pranay Gupta accept?

Health plans from Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Pranay Gupta 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.

Is Pranay Gupta affiliated with any hospitals?

According to CMS data, Pranay Gupta is affiliated with John Randolph Medical Center.

When was this NPI record last updated?

The NPPES record for Pranay Gupta was last updated on April 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.