Organization Active NPI

Glasses Optical Incorporado

  • Optician
  • Ponce, PR
National Provider Identifier
1043855919
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
GLASSES OPTICAL INCORPORADO
Practice address
2939 Ave Emilio Fagot Ste 2
Ponce, PR 00716-3613
Phone
(787) 842-7033
NPI assigned
Nov 14, 2019
Last updated
Aug 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Wilfredo Gaudino, LICENSED OPTICIAN
Title
Owner
Phone
(787) 420-0783

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Optician 156FX1800X Primary

Addresses

Primary practice location

2939 Ave Emilio Fagot Ste 2
Ponce, PR 00716-3613

Mailing address

2939 Ave Emilio Fagot Ste 2
Ponce, PR 00716-3613
Phone (787) 842-7033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200601002168 PR Part B Supplier - Clinic/Group Practice 0547681421 Receives reassigned benefits from 1 practitioner
Practice locations: Ponce, PR

National Provider Directory

National Provider Directory

Locations

2939 Ave Emilio Fagot
Ste 2
Ponce, PR 00716
Phone (787) 842-7033

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1043855919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2939 AVE EMILIO FAGOT STE 2",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163613",
            "telephone_number": "787-842-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2939 AVE EMILIO FAGOT STE 2",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163613",
            "telephone_number": "787-842-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASSES OPTICAL INCORPORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "GAUDINO",
        "authorized_official_first_name": "WILFREDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-420-0783",
        "authorized_official_credential": "LICENSED OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.