Organization Active NPI

Dr. Jose Santisteban Optometra del Desarrollo PSC

  • Optometrist
  • San Sebastian, PR
National Provider Identifier
1326114570
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
159 Issued in PR
Legal business name
DR. JOSE SANTISTEBAN OPTOMETRA DEL DESARROLLO PSC
Practice address
# 1003 Ave. Emerito Estrada Rivera
Suite 7
San Sebastian, PR 00685
Phone
(787) 896-1868
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Dr. Jose Santisteban, O.D.NPI 1134295785
Title
Optometrist
Phone
(787) 896-1868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 159 PR Primary

Addresses

Primary practice location

# 1003 Ave. Emerito Estrada Rivera
Suite 7
San Sebastian, PR 00685

Mailing address

P.O. Box 1648
San Sebastian, PR 00685-1648
Phone (787) 896-1868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080618000747 PR Part B Supplier - Clinic/Group Practice 9032280011 Receives reassigned benefits from 1 practitioner
Practice locations: San Sebastian, PR

National Provider Directory

National Provider Directory

Locations

1003 Ave Emerito Estrada
Ste 7
San Sebastian, PR 00685
Phone (787) 896-1868

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1326114570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1648",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006851648",
            "telephone_number": "787-896-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "# 1003 AVE. EMERITO ESTRADA RIVERA",
            "address_2": "SUITE 7",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "00685",
            "telephone_number": "787-896-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOSE SANTISTEBAN OPTOMETRA DEL DESARROLLO PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "SANTISTEBAN",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "787-896-1868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PR",
            "license": "159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Sebastian, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.