DR. AJAY K GUPTA (M.D.) – Ophthalmology Physician, NPI 1316049265
Ophthalmology Physician
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Profile Insights
NPPES metrics only — not quality of care.
388 OPHTHALMOLOGY in WI
Provider Addresses for DR. AJAY K GUPTA (M.D.)
3113 SAEMANN AVE
SHEBOYGAN, WI 530811957
Phone: (920) 496-4700
Type: Mailing
2414 KOHLER MEMORIAL DR STE 230
SHEBOYGAN, WI 530813129
Phone: (920) 457-4461
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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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: 2022-06-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20191212000905 | I | Ophthalmology | WI | TBD |
| I20220609002699 | I | Ophthalmology | IL | 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 |
|---|---|---|---|---|
| 92014 | Established patient complete exam of visual system | 91 | 89 | $0 |
| 92012 | Established patient problem focused exam of visual system | 78 | 68 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 77 | 77 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 68 | 59 | $0 |
| 92136 | Measurement of corneal curvature and depth of eye | 56 | 31 | $0 |
Insurance plans in this area (ZIP 53081)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | IL | |
| O P T O M E T R Y | IL | |
| O P H T H A L M O L O G Y | IL | |
| O P H T H A L M O L O G Y | IN | |
| O P T O M E T R Y | IL |
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