Individual provider Active NPI

Alejandro Rodriguez, O.D.

  • Optometrist
  • San Juan, PR
National Provider Identifier
1174569404
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
508 Issued in PR
Practice address
1492 Ponce de Leon Ave
Centro Europa Ste 108
San Juan, PR 00907-4008
Phone
(787) 723-2253
Fax
(787) 724-0163
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 508 PR Primary

Addresses

Primary practice location

1492 Ponce de Leon Ave
Centro Europa Ste 108
San Juan, PR 00907-4008

Mailing address

1492 Ponce de Leon
Centro Europa Ste 108
San Juan, PR 00907-4008
Phone (787) 723-2253

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
I20190812001828 PR Practitioner - Optometry 1951489830

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1492 Ave Ponce de Leon
San Juan, PR 00907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Estudio Optometrico Cso LLC Optometrist CurrentSince May 24, 2019 Accepting new patients
Dr. Adalberto Rodriguez Optometrist Past Accepting new patients

Locations

1492 Ave Ponce de Leon
Ste 108
San Juan, PR 00907
Phone (787) 723-2253

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1174569404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 PONCE DE LEON",
            "address_2": "CENTRO EUROPA STE 108",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074008",
            "telephone_number": "787-723-2253",
            "fax_number": "787-724-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 PONCE DE LEON AVE",
            "address_2": "CENTRO EUROPA STE 108",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074008",
            "telephone_number": "787-723-2253",
            "fax_number": "787-724-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.