DR. KEERTHANA NAGAVENKATA BOLISETTY (MD) – Retina Specialist (Ophthalmology) Physician, NPI 1407241284
Retina Specialist (Ophthalmology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,544 OPHTHALMOLOGY in TX
Provider Addresses for DR. KEERTHANA NAGAVENKATA BOLISETTY (MD)
5323 HARRY HINES BLVD
DALLAS, TX 753907201
Phone:
Type: Mailing
1007 W RANDOL MILL RD STE 110
ARLINGTON, TX 760126503
Phone: (817) 617-7678
Fax: (817) 617-7678
Type: Location
5323 Harry Hines Blvd
Dallas, TX 753907201
Phone: (214) 648-0464
Type: Location
3824 N Tarrant Pkwy Ste 310
Fort Worth, TX 762445431
Phone: (817) 617-7678
Fax: (817) 617-7681
Type: Location
3824 N TARRANT PKWY STE 310
FORT WORTH, TX 762445431
Phone: (817) 617-7678
Fax: (817) 617-7681
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $420.
Total Amount is formed as General ($420) + Research ($0) + Ownership ($0) = $420.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Astellas Pharma US Inc ($195).
Total Amount
$420
General + Research + Ownership
Payments
9
Total payment records
General Amount
$420
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $195 |
| Regeneron Healthcare Solutions, Inc. | $112 |
| Alimera Sciences, Inc. | $35 |
| Harrow Eye, LLC | $30 |
| Genentech USA, Inc. | $25 |
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: 2019-06-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190626001884 | I | Ophthalmology | TX | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 92134 | Imaging of retina | 346 | 188 | $0 |
| J0178 | Injection, aflibercept, 1 mg | 286 | 53 | $0 |
| 67028 | Injection of drug into eye | 163 | 68 | $0 |
| 92202 | Extended exam of the back part of the eye with optic nerve drawing | 125 | 103 | $0 |
| 92014 | Established patient complete exam of visual system | 112 | 90 | $0 |
Insurance plans in this area (ZIP 75390)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | TX |
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