Individual provider Active NPI

Paul Velazquez, O.D.

  • Optometrist
  • Carolina, PR
National Provider Identifier
1083797583
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
263 Issued in PR
Practice address
Local #203
Carolina, PR 00988
Phone
(787) 752-2485
Fax
(787) 757-4885
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 263 PR Primary

Addresses

Primary practice location

Local #203
Carolina, PR 00988

Mailing address

245 Plaza Carolina
Carolina, PR 00985
Phone (787) 752-2485

Other names 1

  • Paul Rivera Other name

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
I20081118000433 PR Practitioner - Optometry 9739249939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
263PRMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Instituto de Ojos Y Piel, Inc Optometrist CurrentSince May 20, 2012 Accepting new patients
Instituto de Ojos Y Piel CurrentSince May 20, 2012 Accepting new patients
Instituto de Ojos Y Piel, Inc Past Accepting new patients

Locations

11310 Ave 65 Infanteria
#3
Carolina, PR 00987
Phone 7877692477325

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083797583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 PLAZA CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-752-2485",
            "fax_number": "787-757-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOCAL #203",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00988",
            "telephone_number": "787-752-2485",
            "fax_number": "787-757-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "PAUL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "RIVERA",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.