Active NPI 1528072741 Individual Practitioner Female Practitioner

Dr. Sushma Rai , MD

Ophthalmology • Phoenix, AZ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Sushma Rai, MD is a certified Ophthalmology practicing in Phoenix, AZ. With approximately 41 years of clinical experience since completing medical education in 1985, Dr. Rai delivers high-quality medical care to the local community at 4212 N 16TH ST.

Dr. Rai is affiliated with Dhew Ind Hlth Sv Hlth Svs And Mntl Hlth Adm and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, exam of visual field with intermediate testing, examination of cornea and iris using lens device and slit lamp. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4212 N 16th St

Phoenix, AZ 850165319

Telephone 6022631200

Fax 6022631619

Associated Practice Facility / Clinic

🏢 Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm Facility NPI 1083643738

Medicare Profile & Education

Medical School

Other

Graduation Year

1985

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Phoenix, AZ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

41 Yrs +16.9 yrs vs City Avg

City Avg: 24.1 Yrs

State Avg: 27.4 Yrs

Regional Practice Density

100 Specialists

Practicing in Phoenix, AZ (384 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

30.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Rai (41 Years) 41 Yrs

Phoenix Specialty Average (24.1 Years) 24.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	98	65	$122.97	$93.83
92082 Exam of visual field with intermediate testing	52	45	$44.00	$19.88
92020 Examination of cornea and iris using lens device and slit lamp	51	50	$26.00	$19.53
76514 Ultrasound scan of cornea to determine thickness	45	45	$11.00	$7.46
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$160.00	$128.74
76519 Ultrasound of eye for determination of lens power	21	20	$64.00	$28.99
99213 Established patient office or other outpatient visit, typically 15 minutes	18	17	$87.00	$63.61
92134 Imaging of retina	13	12	$37.46	$23.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	30	$167.00	$95.86
92083 Exam of visual field with extended testing	26	22	$74.00	$26.37
92133 Imaging of optic nerve	17	17	$60.00	$21.02
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	12	$54.00	$34.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	33	$167.00	$97.04
92083 Exam of visual field with extended testing	30	28	$74.00	$26.51
92014 Established patient complete exam of visual system	11	11	$212.00	$75.60

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	57	49	$167.00	$99.13
92083 Exam of visual field with extended testing	38	29	$74.00	$26.91
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	22	$54.00	$35.78
99213 Established patient office or other outpatient visit, typically 15 minutes	17	14	$109.00	$67.15
92133 Imaging of optic nerve	14	14	$60.00	$21.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$275.00	$135.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	36	$167.00	$79.54
92083 Exam of visual field with extended testing	39	34	$74.00	$27.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	17	$54.00	$25.93
92012 Established patient problem focused exam of visual system	18	16	$141.00	$52.80
99213 Established patient office or other outpatient visit, typically 15 minutes	13	11	$109.00	$51.62
92133 Imaging of optic nerve	13	13	$60.00	$22.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$275.00	$130.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	50	39	$99.46	$52.85
92083 Exam of visual field with extended testing	45	40	$57.25	$28.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	32	27	$139.34	$78.66
92014 Established patient complete exam of visual system	31	29	$141.64	$79.83
92250 Photography of the retina	26	26	$44.88	$22.03
92136 Measurement of corneal curvature and depth of eye	20	18	$56.11	$31.62
92020 Examination of cornea and iris using lens device and slit lamp	20	20	$41.60	$21.30
66984 Removal of cataract with insertion of lens	16	13	$1266.75	$640.62
92133 Imaging of optic nerve	15	15	$51.74	$22.38
92004 New patient complete exam of visual system	13	13	$176.06	$99.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	31	26	$141.64	$78.91
92083 Exam of visual field with extended testing	23	23	$49.68	$27.64
92020 Examination of cornea and iris using lens device and slit lamp	23	22	$38.00	$20.97
92250 Photography of the retina	14	14	$41.76	$21.69
92133 Imaging of optic nerve	13	13	$49.68	$22.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	347	217	$120.00	$81.75
92014 Established patient complete exam of visual system	322	277	$170.00	$119.57
92083 Exam of visual field with extended testing	265	231	$120.00	$61.38
J9190 Injection, fluorouracil, 500 mg	116	51	$8.00	$1.67
68200 Injection into conjunctiva	111	51	$241.35	$40.72
92136 Measurement of corneal curvature and depth of eye	111	54	$97.25	$40.54
92133 Imaging of optic nerve	81	81	$95.00	$35.66
92020 Examination of cornea and iris using lens device and slit lamp	77	73	$65.00	$26.10
92250 Photography of the retina	67	66	$110.00	$63.65
66984 Removal of cataract with insertion of lens	61	39	$2800.00	$591.90
65855 Laser repair to improve eye fluid flow	45	35	$1200.00	$237.00
66172 Creation of eye fluid drainage tract	39	34	$2090.00	$1144.93
66761 Creation of eye fluid drainage tracts in iris using a laser, per session	23	13	$1200.00	$228.75
76514 Ultrasound scan of cornea to determine thickness	17	17	$70.00	$13.73
66170 Creation of eye fluid drainage tract	14	14	$1655.00	$1060.65

Medical Specialties & State Licenses

CMS Verified: 2026-06-25

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License AZ 49918

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.

Hospital & Practice Group Affiliations

Dhew Ind Hlth Sv Hlth Svs And Mntl Hlth Adm

4212 N 16th St, Phoenix, AZ 850165319

Phone: 6022631200

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Wendy Razo

Registered Nurse - Obstetric, High-Risk

NPI 1003045329

Thomas Hall , RN

Registered Nurse

NPI 1003138942

Registered Nurse

Dr. Umar Iqbal , MD

Family Medicine

NPI 1003170077

Doctor of Medicine (M.D.)

Sharla Wyatt , RN

Registered Nurse

NPI 1003208299

Registered Nurse

Dr. Katelyn Peltier , PharmD

Pharmacist

NPI 1003240318

Doctor of Pharmacy (Pharm.D.)

Laura Molander

Pharmacist

NPI 1003283623

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location June 25, 2026

Registered at 4212 N 16TH ST, PHOENIX, AZ 850165319 (Tel: 6022631200)

📍

Updated Business Mailing Address June 25, 2026

Registered at PO BOX 95460, CLEVELAND, OH 441010033 (Tel: 6025816076)

✅

NPI Profile Active February 12, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location February 12, 2015

Registered at 4800 N 22ND ST, PHOENIX, AZ 850164701 (Tel: 6029551000)

📍

Updated Business Mailing Address February 12, 2015

Registered at 4800 N 22ND ST, PHOENIX, AZ 850164701 (Tel: 6029551000)

👤

Provider Name / Credentials Updated February 12, 2015

Recorded as SUSHMA RAI, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 12, 2015

Ophthalmology (License #49918 in AZ)

🟢

Initial NPI Registration & Enumeration July 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1528072741

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 27, 2006

Last Update: June 25, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 95460

Cleveland, OH 441010033

Phone: 6025816076

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.