Individual provider Active NPI

Zaira Teresa Olivencia Henriquez, OD

  • Optometrist
  • San Sebastian, PR
National Provider Identifier
1164843744
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
714 Issued in PR
Practice address
281 Calle Ruiz Belvis
San Sebastian, PR 00685-2335
Phone
(787) 896-7040
NPI assigned
Dec 26, 2013
Last updated
Feb 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 714 PR Primary

Addresses

Primary practice location

281 Calle Ruiz Belvis
San Sebastian, PR 00685-2335

Mailing address

Urb .Repto. Universidad Calle 4 L 24
San German, PR 00683-3831
Phone (787) 677-4074

Other practice location 1

975 Ave Hostos Ste 2021
Mayaguez, PR 00680-1259
Phone (787) 677-4074

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
I20170515001802 PR Practitioner - Optometry 4688951924 Reassigns benefits to 1 organization
Practice locations: San Sebastian, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
714PRMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Ojos Centro Optico LLC Optometrist CurrentSince Nov 23, 2022 Accepting new patients
Yolanda Rodriguez Morales PastSince Mar 1, 2020 Accepting new patients

Locations

281 Calle Ruiz Belvis
San Sebastian, PR 00685
Phone (787) 896-7040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1164843744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB .REPTO. UNIVERSIDAD CALLE 4 L 24",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006833831",
            "telephone_number": "787-677-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 CALLE RUIZ BELVIS",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006852335",
            "telephone_number": "787-896-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 Ave Hostos Ste 2021",
            "address_purpose": "LOCATION",
            "city": "Mayaguez",
            "state": "PR",
            "postal_code": "006801259",
            "country_code": "US",
            "telephone_number": "787-677-4074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVENCIA HENRIQUEZ",
        "first_name": "ZAIRA",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-26",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Sebastian, PR

Sources for this page

Verify at the official NPI Registry.