DR. GAUTAM VANGIPURAM (M.D) – Retina Specialist (Ophthalmology) Physician, NPI 1780052233

DR. GAUTAM VANGIPURAM (M.D) is a healthcare provider. based in Saint louis, Missouri. specializing in OPHTHALMOLOGY. They hold the professional credentials M.D. They hold a License No. 2019018140 (MO). The NPI Number for DR. GAUTAM VANGIPURAM (M.D) is 1780052233

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
DR. GAUTAM VANGIPURAM (M.D)
NPI
1780052233
Phone
(314) 367-1181
Address
1600 S BRENTWOOD BLVD STE 800
Enumeration Date
14 September 2015
Last Update Date
10 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
7147384620
Graduation Year
2015 (11 years ago)
PAC ID
2961737721
Group Practice PAC ID
8921906017
Professional Enrollment ID
I20211029000238
Address ID
CA928353432FU301XXRDXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:10State licenses:2Digital endpointsOther names

444 OPHTHALMOLOGY in MO

Provider Addresses for DR. GAUTAM VANGIPURAM (M.D)

  • 1600 S BRENTWOOD BLVD STE 800

    SAINT LOUIS, MO 631441317

    Phone: (314) 367-1181

    Type: Mailing

  • 17 THE BOULEVARD SAINT LOUIS

    SAINT LOUIS, MO 631171118

    Phone: (314) 367-1181

    Fax: (314) 968-5117

    Type: Location

  • 1900 W GARVEY AVE S UNIT 335

    WEST COVINA, CA 917902656

    Phone: (626) 305-9100

    Fax: (626) 305-9150

    Type: Mailing

  • 2619 E COLORADO BLVD STE 150

    PASADENA, CA 911073747

    Phone: (626) 793-4168

    Fax: (626) 793-6256

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 19 Open Payments records for all available years, with a total value of $644.

Total Amount is formed as General ($644) + Research ($0) + Ownership ($0) = $644.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Astellas Pharma US Inc ($203).

Total Amount

$644

General + Research + Ownership

Payments

19

Total payment records

General Amount

$644

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-10-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211029000238IOphthalmologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92134Imaging of retina10868$0
99214Established patient office or other outpatient visit, 30-39 minutes5742$0
67028Injection of drug into eye3724$0
99204New patient office or other outpatient visit, 45-59 minutes3333$0
J9035Injection, bevacizumab, 10 mg2815$0
View full utilization report →

Insurance plans in this area (ZIP 63144)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921906017View full group profile
NameSpecialtyState
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YCA
-CA
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YWV

Reviews

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Frequently asked questions

Can I verify DR. GAUTAM VANGIPURAM (M.D) with an NPI only?
You can start verification with NPI 1780052233 for DR. GAUTAM VANGIPURAM (M.D), then check state licensing separately.
Is DR. GAUTAM VANGIPURAM (M.D) listed as active for patients and plans?
The listing shows DR. GAUTAM VANGIPURAM (M.D) as active in the NPI system.
What taxonomy line describes DR. GAUTAM VANGIPURAM (M.D)?
For research purposes, treat DR. GAUTAM VANGIPURAM (M.D) as Retina Specialist (Ophthalmology) Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. GAUTAM VANGIPURAM (M.D) based?
DR. GAUTAM VANGIPURAM (M.D) is tied to Saint Louis, Missouri in the data we show; additional addresses may exist on the full record.
Why does DR. GAUTAM VANGIPURAM (M.D) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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