Individual provider Active NPI

Cheryl Rodriguez, OD OPTOMETRY DOCTOR

  • Optometrist
  • Cayey, PR
National Provider Identifier
1154419992
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
619 Issued in PR
Practice address
Bo Montellano KM 55 1
Plaza Cayey
Cayey, PR 00736
Phone
(787) 738-7310
Fax
(787) 738-7022
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 619 PR Primary

Addresses

Primary practice location

Bo Montellano KM 55 1
Plaza Cayey
Cayey, PR 00736

Mailing address

Urb Heavenly View
#26
Gurabo, PR 00778
Phone (787) 922-5847

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
I20051114000836 PR Practitioner - Optometry 9032138508 Reassigns benefits to 1 organization
Practice locations: Humacao, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
619PRMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Optica LLC Optometrist CurrentSince Nov 1, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1154419992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB HEAVENLY VIEW",
            "address_2": "#26",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-922-5847",
            "fax_number": "787-738-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO MONTELLANO KM 55 1",
            "address_2": "PLAZA CAYEY",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-738-7310",
            "fax_number": "787-738-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CHERYL",
        "credential": "OD OPTOMETRY DOCTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayey, PR

Sources for this page

Verify at the official NPI Registry.