Individual provider Active NPI

Rosaleen Marie Bobonis Quiles, OD

  • Optometrist
  • Bayamon, PR
National Provider Identifier
1013155084
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
656 Issued in PR
Practice address
P60 Ave Santa Juanita
Bayamon, PR 00956-4954
Phone
(787) 995-2450
NPI assigned
Jan 29, 2009
Last updated
Sep 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 656 PR Primary

Addresses

Primary practice location

P60 Ave Santa Juanita
Bayamon, PR 00956-4954

Mailing address

1697 Calle Saltillo
Venus Gardens
San Juan, PR 00926-4641

Other practice location 1

W16 Blvd David Cordova Torrech
Toa Baja, PR 00949-4707
Phone (787) 248-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090814000258 PR Practitioner - Optometry 0648324343 Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
656PRMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JK Optical Inc. Past Accepting new patients
New Vision Optica Inc Optometrist Past Accepting new patients
New Vision Optica Optometrist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1013155084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1697 CALLE SALTILLO",
            "address_2": "VENUS GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "P60 AVE SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564954",
            "telephone_number": "787-995-2450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W16 Blvd David Cordova Torrech",
            "address_purpose": "LOCATION",
            "city": "Toa Baja",
            "state": "PR",
            "postal_code": "009494707",
            "country_code": "US",
            "telephone_number": "787-248-1222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBONIS QUILES",
        "first_name": "ROSALEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.