Individual provider Active NPI

Yeissa J. Rodriguez Cruz, O.D.

  • Optometrist
  • Humacao, PR
National Provider Identifier
1346295573
Registry record updated Sep 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
582 Issued in PR
Practice address
50 Calle Victoria Ste 2
Humacao, PR 00791-4494
Phone
(939) 640-9161
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3832 FL
Optometrist 152W00000X 582 PR Primary

Addresses

Primary practice location

50 Calle Victoria Ste 2
Humacao, PR 00791-4494

Mailing address

Condominio Lago Playa 3000
Calle Coral Apt 3012
Toa Baja, PR 00949-3054
Phone (787) 635-4475

Other practice location 1

Bird Leon
6 Jorge
Fajardo, PR 00738
Phone (787) 860-6060

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
I20061003000565 PR Practitioner - Optometry 1658376207 Practice locations: Caguas, PR; Canovanas, PR; Humacao, PR

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Edif E Med Professional Ctr
Carr 3 KM 19.9
Canovanas, PR 00729-0001
Phone (787) 256-6060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3832FLMDOptometrist
582PRMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Visual Healers Optica Optometrist Past Accepting new patients
Pauling Firm Inc Optometrist PastSince Aug 18, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599955200000",
    "number": "1346295573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CONDOMINIO LAGO PLAYA 3000",
            "address_2": "CALLE CORAL APT 3012",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009493054",
            "telephone_number": "787-635-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CALLE VICTORIA STE 2",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914494",
            "telephone_number": "939-640-9161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "BIRD LEON",
            "address_2": "6 JORGE",
            "address_purpose": "LOCATION",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "country_code": "US",
            "telephone_number": "787-860-6060",
            "fax_number": "787-860-6061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ CRUZ",
        "first_name": "YEISSA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-09-13",
        "certification_date": "2020-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3832",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.