Veronica Camarillo OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

VERONICA CAMARILLO OD PC

Practice address

6050 US Highway 6
Portage, IN 46368-5047

Phone

(219) 762-7862

NPI assigned

Jul 18, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Veronica M Camarillo, ODNPI 1477657419

Title

President

Phone

(219) 973-3712

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Veronica M. Camarillo, O.D.

  • Optometrist
  • Portage, IN
  • NPI 1477657419
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1073166013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W 4TH PL",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463424918",
            "telephone_number": "219-973-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 US HIGHWAY 6",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685047",
            "telephone_number": "219-762-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERONICA CAMARILLO OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-18",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "CAMARILLO",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-973-3712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200489900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Portage, IN
• Providers in Portage, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.