Active NPI
Marta Ivelise Ruiz, OP
- Optician
- Fajardo, PR
National Provider Identifier
1124867585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1465
- Practice address
- 150 Carr 940 Ste 180
Fajardo, PR 00738-3653 - Phone
- (787) 860-1050
- Fax
- (787) 860-1111
- NPI assigned
- May 23, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 1465 | PR | Primary |
Addresses
Primary practice location
150 Carr 940 Ste 180
Fajardo, PR 00738-3653
Mailing address
150 Carr 940 Ste 180
Fajardo, PR 00738-3653
Phone (787) 860-1050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1465 | PR | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1124867585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 CARR 940 STE 180",
"city": "FAJARDO",
"state": "PR",
"postal_code": "007383653",
"telephone_number": "787-860-1050",
"fax_number": "787-860-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 CARR 940 STE 180",
"city": "FAJARDO",
"state": "PR",
"postal_code": "007383653",
"telephone_number": "787-860-1050",
"fax_number": "787-860-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "MARTA",
"middle_name": "IVELISE",
"credential": "OP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-23",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "PR",
"license": "1465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fajardo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.