Individual provider Active NPI

Carmen M Suarez-Castro, O.D

  • Low Vision Rehabilitation Optometrist
  • San Juan, PR
National Provider Identifier
1295816395
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
193 Issued in PR
Practice address
369 Ave Domenech
San Juan, PR 00918-3708
Phone
(787) 754-0814
Fax
(787) 756-5823
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Low Vision Rehabilitation Optometrist 152WL0500X 193 PR Primary

Addresses

Primary practice location

369 Ave Domenech
San Juan, PR 00918-3708

Mailing address

Ave. Domenech 369
Hato Rey, PR 00918
Phone (787) 754-0814

Other identifiers 5

IdentifierTypeStateIssuer
077108OtherPRPROVIDER CRUZ AZUL
58033OtherPRPROVIDER T-SSS
3465OtherPRPROVIDER FIRST MEDICAL
624OtherPRPROVIDER COSVI
9170025OtherPRPROVIDER HUMANA PR

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
I20091130000519 PR Practitioner - Optometry 2264571504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

369 Calle Manuel Domenech
San Juan, PR 00918-3708
Phone (787) 754-0814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
193PRMDMedical Physician Assistant

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295816395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE. DOMENECH 369",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-754-0814",
            "fax_number": "787-756-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183708",
            "telephone_number": "787-754-0814",
            "fax_number": "787-756-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ-CASTRO",
        "first_name": "CARMEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "PR",
            "license": "193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER CRUZ AZUL",
            "identifier": "077108",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER  T-SSS",
            "identifier": "58033",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER FIRST MEDICAL",
            "identifier": "3465",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER COSVI",
            "identifier": "624",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER HUMANA PR",
            "identifier": "9170025",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.