Individual provider Active NPI

Luis Francisco Rivera Sandoval, OD

  • Optometrist
  • Hatillo, PR
National Provider Identifier
1255802401
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005184 Issued in MI
Practice address
PR-2 KM 84.2
Hatillo, PR 00659
Phone
(787) 544-7279
Fax
(787) 820-5409
NPI assigned
Dec 16, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 741-0438 PR
Optometrist 152W00000X 3541-35 WI
Optometrist 152W00000X 4901005184 MI Primary

Addresses

Primary practice location

PR-2 KM 84.2
Hatillo, PR 00659

Mailing address

PR-2 KM 84.2
Hatillo, PR 00659
Phone (787) 544-7279

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
I20240521004706 PR Practitioner - Optometry 4284076340 Practice locations: Camuy, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005184MIMDOptometrist
741-0438PRMDOptometrist
3541-35WIMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1255802401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PR-2 KM 84.2",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "00659",
            "telephone_number": "787-544-7279",
            "fax_number": "787-820-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PR-2 KM 84.2",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "00659",
            "telephone_number": "787-544-7279",
            "fax_number": "787-820-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA SANDOVAL",
        "first_name": "LUIS",
        "middle_name": "FRANCISCO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "741-0438",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3541-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatillo, PR

Sources for this page

Verify at the official NPI Registry.