Individual provider Active NPI

Wendy I Nazario Ortiz, OPTOMETRA

  • Optometrist
  • Lajas, PR
National Provider Identifier
1093991416
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270 Issued in PR
Practice address
Calle Jose M. Toro Basora #4
Lajas, PR 00667
Phone
(787) 899-1800
Fax
(787) 899-1800
NPI assigned
Jan 16, 2008
Last updated
Dec 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270 PR Primary

Addresses

Primary practice location

Calle Jose M. Toro Basora #4
Lajas, PR 00667

Mailing address

P.O. Box 227
Lajas, PR 00667
Phone (787) 899-1800

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
I20191211002934 PR Practitioner - Optometry 5092014183 Practice locations: Lajas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Opti-Vision Center Optometrist PastSince Dec 1, 2019 Accepting new patients

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, 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": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1093991416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 227",
            "city": "LAJAS",
            "state": "PR",
            "postal_code": "00667",
            "telephone_number": "787-899-1800",
            "fax_number": "787-899-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE JOSE M. TORO BASORA #4",
            "city": "LAJAS",
            "state": "PR",
            "postal_code": "00667",
            "telephone_number": "787-899-1800",
            "fax_number": "787-899-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIO ORTIZ",
        "first_name": "WENDY",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lajas, PR

Sources for this page

Verify at the official NPI Registry.