Individual provider Active NPI

Rafael A Fernandez, O.D.

  • Optometrist
  • Carolina, PR
National Provider Identifier
1235212127
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
260 Issued in PR
Practice address
Baldorioty de Castro-Exp
Carolina, PR 00985
Phone
(787) 750-6850
Fax
(787) 750-6755
NPI assigned
Oct 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 260 PR Primary

Addresses

Primary practice location

Baldorioty de Castro-Exp
Carolina, PR 00985

Mailing address

PO Box 9792
San Juan, PR 00908-0792
Phone (787) 721-4365

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
I20150506000455 PR Practitioner - Optometry 9537488978 Practice locations: Manti, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
260PRMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235212127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9792",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009080792",
            "telephone_number": "787-721-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BALDORIOTY DE CASTRO-EXP",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-750-6850",
            "fax_number": "787-750-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "RAFAEL",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.