NPIMap

Organization Active NPI

Optometras Pico, Tort Y Gorbea, LLC

  • Optometrist
  • Bayamon, PR
National Provider Identifier
1255390340
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OPTOMETRAS PICO, TORT Y GORBEA, LLC
Practice address
J12A Calle 2
Ext. Villa Rica
Bayamon, PR 00959-5077
Phone
(787) 780-0677
Fax
(787) 740-5070
NPI assigned
Mar 20, 2006
Last updated
Oct 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Authorized official

Name
Dr. Maria H. Gorbea, O.D.NPI 1912976051
Title
Partner
Phone
(787) 780-0677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

J12A Calle 2
Ext. Villa Rica
Bayamon, PR 00959-5077

Mailing address

J12A Calle 2
Ext. Villa Rica
Bayamon, PR 00959-5077
Phone (787) 780-0677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160412000403 PR Part B Supplier - Clinic/Group Practice 3779881560 Receives reassigned benefits from 2 practitioners
Practice locations: Bayamon, PR
O20160620000879 PR DME Supplier - Physician - Optometrist 3779881560 Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

J12A Calle 2
Bayamon, PR 00959
Phone (787) 780-0677

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445472000000",
    "number": "1255390340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "J12A CALLE 2",
            "address_2": "EXT. VILLA RICA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595077",
            "telephone_number": "787-780-0677",
            "fax_number": "787-740-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "J12A CALLE 2",
            "address_2": "EXT. VILLA RICA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595077",
            "telephone_number": "787-780-0677",
            "fax_number": "787-740-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRAS PICO, TORT Y GORBEA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2015-10-22",
        "status": "A",
        "authorized_official_last_name": "GORBEA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "787-780-0677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.