Individual provider Active NPI

Wilfredo Rosado-Maldonado, O.D.

  • Optometrist
  • Vega Alta, PR
National Provider Identifier
1275689234
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
336 Issued in PR
Practice address
Calle Luis Munoz Rivera 58-a
Vega Alta, PR 00692
Phone
(787) 883-6406
Fax
(787) 883-7142
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 336 PR Primary

Addresses

Primary practice location

Calle Luis Munoz Rivera 58-a
Vega Alta, PR 00692

Mailing address

PO Box 2138
Vega Alta, PR 00692-2138
Phone (787) 883-6406

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
I20110531000417 PR Practitioner - Optometry 0345427365 Practice locations: Vega Alta, PR

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

58 -A Calle Luis Munoz Rivera
Vega Alta, PR 00692
Phone (787) 883-6406

58 Calle a
Vega Alta, PR 00692

PO Box
Suite 2138
Vega Alta, PR 00692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
336PRMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1275689234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2138",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006922138",
            "telephone_number": "787-883-6406",
            "fax_number": "787-883-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE LUIS MUNOZ RIVERA 58-A",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "00692",
            "telephone_number": "787-883-6406",
            "fax_number": "787-883-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO-MALDONADO",
        "first_name": "WILFREDO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Alta, PR

Sources for this page

Verify at the official NPI Registry.