Individual provider Active NPI

Rafael A. Gallardo Mendez, M.D.

  • Ophthalmology Physician
  • San Juan, PR
National Provider Identifier
1255318812
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
7071 Issued in PR
Practice address
1449 Calle Americo Salas
Edif. Pavia II, Suite 203
San Juan, PR 00909-2100
Phone
(787) 725-6001
Fax
(787) 724-6070
NPI assigned
Dec 26, 2005
Last updated
Sep 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 7071 PR Primary

Addresses

Primary practice location

1449 Calle Americo Salas
Edif. Pavia II, Suite 203
San Juan, PR 00909-2100

Mailing address

PO Box 362158
San Juan, PR 00936-2158
Phone (787) 725-6001

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526000686 PR Practitioner - Ophthalmology 4880723063 Practice locations: San Juan, PR; Humacao, PR

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1449 Calle Americo Salas
San Juan, PR 00909-2100
Phone (787) 725-6001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7071PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
La Nueva Optica Past 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, 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": "1135555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1255318812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 362158",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009362158",
            "telephone_number": "787-725-6001",
            "fax_number": "787-724-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 CALLE AMERICO SALAS",
            "address_2": "EDIF. PAVIA II, SUITE 203",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092100",
            "telephone_number": "787-725-6001",
            "fax_number": "787-724-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLARDO MENDEZ",
        "first_name": "RAFAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-26",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "7071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.