Individual provider Active NPI

Jayro Loya Grijalva, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1144914599
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003751 Issued in PA
Practice address
3586 Aramingo Ave
Philadelphia, PA 19134-4606
Phone
(215) 535-4264
NPI assigned
Jun 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2893 MD
Optometrist 152W00000X OEG003751 PA Primary

Addresses

Primary practice location

3586 Aramingo Ave
Philadelphia, PA 19134-4606

Mailing address

3586 Aramingo Ave
Philadelphia, PA 19134-4606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231214003111 PA Practitioner - Optometry 5890144992 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2893MDMDOptometrist
OEG003751PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Dec 4, 2023 Accepting new patients
Visionworks, Inc CurrentSince Dec 4, 2023 Accepting new patients
Loya Eye Care LLC Optometrist Past Accepting new patients

Locations

560 Millcreek Mall
Erie, PA 16565
Phone (814) 868-8540

2300 E Lincoln Hwy
Langhorne, PA 19047
Phone (215) 750-3760

3586 Aramingo Ave
Philadelphia, PA 19134
Phone (215) 535-4264

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": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1144914599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3586 ARAMINGO AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3586 ARAMINGO AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344606",
            "telephone_number": "215-535-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOYA GRIJALVA",
        "first_name": "JAYRO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-07",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2893",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.