Active NPI
Ezequiel Molina Diaz, OD
- Optometrist
- Comerio, PR
National Provider Identifier
1124848874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 779
- Practice address
- 34 Calle Georgetti
Comerio, PR 00782-2539 - Phone
- (787) 735-1974
- NPI assigned
- Oct 16, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 779 | PR | Primary |
Addresses
Primary practice location
34 Calle Georgetti
Comerio, PR 00782-2539
Mailing address
HC 6 Box 12424
Corozal, PR 00783-7815
Phone (939) 252-4502
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251208001317 | PR | Practitioner - Optometry | 7517450570 | Practice locations: Comerio, PR; Orocovis, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- International American University at Puerto Rico - School of Optometry, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
100 Ave del Espiritu Santo
Apt 1301
Caguas, PR 00725-3026
34 Calle Gerardo Nieves Mercado
Comerio, PR 00782-2592
Phone (787) 735-1974
Carr 155 KM 30
Clinica Visual Orocovis
Orocovis, PR 00720-9702
Phone (787) 867-1234
HC 6 Box
Suite 12424
Corozal, PR 00783
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729036800000",
"number": "1124848874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 6 BOX 12424",
"city": "COROZAL",
"state": "PR",
"postal_code": "007837815",
"telephone_number": "939-252-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 CALLE GEORGETTI",
"city": "COMERIO",
"state": "PR",
"postal_code": "007822539",
"telephone_number": "787-735-1974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLINA DIAZ",
"first_name": "EZEQUIEL",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-16",
"last_updated": "2024-10-16",
"certification_date": "2024-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Comerio, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.