Individual provider Active NPI

Monica Marie Pacheco, MD

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Manati, PR
National Provider Identifier
1164670980
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
15390 Issued in PR
Practice address
200 Calle Hernandez Carrion Ste 301
Manati, PR 00674-4652
Phone
(939) 440-9200
Fax
(301) 987-0097
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D68147 MD
Ophthalmology Physician 207W00000X 15390 PR
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X 15390 PR Primary

Addresses

Primary practice location

200 Calle Hernandez Carrion Ste 301
Manati, PR 00674-4652

Mailing address

15235 Shady Grove Rd Ste 101
Rockville, MD 20850-6273
Phone (301) 330-1366

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D68147MDMDOphthalmology Physician
15390PRMDPediatric Ophthalmology and Strabismus Specialist Physician Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ojitos Oftalmologia Pediatrica CSP Ophthalmology Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1164670980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15235 SHADY GROVE RD STE 101",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506273",
            "telephone_number": "301-330-1366",
            "fax_number": "301-987-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CALLE HERNANDEZ CARRION STE 301",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006744652",
            "telephone_number": "939-440-9200",
            "fax_number": "301-987-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "MONICA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D68147",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "15390",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "PR",
            "license": "15390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.