Individual provider Active NPI

Roberto Andres Cobian Gonzalez

  • Optometrist
  • San Sebastian, PR
National Provider Identifier
1013609502
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
771472 Issued in PR
Practice address
200 Calle Ruiz Belvis
San Sebastian, PR 00685-1724
Phone
(787) 280-6986
NPI assigned
May 23, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 771472 PR Primary

Addresses

Primary practice location

200 Calle Ruiz Belvis
San Sebastian, PR 00685-1724

Mailing address

PO Box 1194
San Sebastian, PR 00685-1194
Phone (787) 457-1692

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
I20241015000034 PR Practitioner - Optometry 8921530031 Practice locations: San Sebastian, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
771472PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctora Magaly Gonzalez Mestre Optometra, CSP CurrentSince May 28, 2023 Accepting new patients

Locations

200 Calle Ruiz Belvis
San Sebastian, PR 00685
Phone (787) 280-6986

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1013609502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1194",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006851194",
            "telephone_number": "787-457-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CALLE RUIZ BELVIS",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006851724",
            "telephone_number": "787-280-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBIAN GONZALEZ",
        "first_name": "ROBERTO",
        "middle_name": "ANDRES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "771472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Sebastian, PR

Sources for this page

Verify at the official NPI Registry.