Ajay K. Gupta, M.D.
NPI 1316049265ActiveIndividual· Ophthalmology· Sheboygan, WI
Ophthalmology (M.D.) in Sheboygan, Wisconsin, trained at University of Cincinnati College of Medicine (class of 1999). In 2024 Medicare paid $19,091 for 55 patients, and Part D covered 287 of their prescriptions, 60% of them generic.
Overview
| NPI | 1316049265 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | Yes |
| NPI issued | Sep 2, 2006 |
| Last updated in NPPES | Oct 5, 2026 |
| Certified by provider | Sep 30, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology Primary | 207W00000X | 036158921 | IL |
| Ophthalmology | 207W00000X | 71682-20 | WI |
| Ophthalmology | 207W00000X | OH 35 084276 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Ophthalmology (IL); Practitioner - Ophthalmology (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 55 |
|---|---|
| Services billed | 164 across 17 procedure codes |
| Paid by Medicare | $19,091 |
Part D prescriptions in 2024
| Prescriptions (claims) | 287 · 535 30-day fills |
|---|---|
| Patients | 115 |
| Total drug cost | $26,074 |
| Generic share | 60% of claims |
Education and affiliations
| Medical school | University of Cincinnati College of Medicine |
|---|---|
| Graduation year | 1999 |
| Medicare specialty | Ophthalmology |
Medical group
- Rockford Eye and Laser Center LtdLoves Park, IL · 6 clinicians
Hospital affiliation
- Javon Bea HospitalRockford, IL
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other ophthalmologists in Sheboygan
- 1316394596
- 1609184365
- 1750358693
- 1225457534
- 1457654261
- 1558318659
- 1629039961
- 1134129497
- 1407942410
- 1215044128