Individual provider Active NPI

Carmen H Benabe, O.D.

  • Optometrist
  • San Juan, PR
National Provider Identifier
1023344843
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
624 Issued in PR
Practice address
201 Ave de Diego Ste 40
San Juan, PR 00927-5828
Phone
(787) 637-1464
NPI assigned
Oct 29, 2009
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 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 624 PR Primary

Addresses

Primary practice location

201 Ave de Diego Ste 40
San Juan, PR 00927-5828

Mailing address

PO Box 194483
San Juan, PR 00919-4483
Phone (787) 637-1464

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
I20131122000521 PR Practitioner - Optometry 8426284456 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
624PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Caribe Opti Lab (Dba Optics Eye Care) CurrentSince Dec 15, 2024 Accepting new patients
Optics Eye Care Inc CurrentSince Feb 8, 2026 Accepting new patients
Benabe Visual Clinic Optometrist PastSince Sep 11, 2022 Accepting new patients

Locations

201 Ave de Diego
Ste 40
San Juan, PR 00927
Phone (787) 782-6664

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": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1023344843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194483",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009194483",
            "telephone_number": "787-637-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 AVE DE DIEGO STE 40",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009275828",
            "telephone_number": "787-637-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENABE",
        "first_name": "CARMEN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-29",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.