Individual provider Active NPI

Karina Michelle Mercado Rivera, OD

  • Optometrist
  • Aguada, PR
National Provider Identifier
1356812168
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
739-432 Issued in PR
Practice address
Carr 115 KM 24.6 Bo Asomante
Aguada, PR 00602
Phone
(787) 589-7468
NPI assigned
Dec 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9616T TX
Optometrist 152W00000X 739-432 PR Primary

Addresses

Primary practice location

Carr 115 KM 24.6 Bo Asomante
Aguada, PR 00602

Mailing address

205 Oeste Calle de la Candelaria
Mayaguez, PR 00682
Phone (787) 918-1749

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
I20190405000678 PR Practitioner - Optometry 7719228485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
739-432PRMDOptometrist
9616TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optica Prisma Optometrist CurrentSince Jun 24, 2022 Accepting new patients

Locations

205 Calle de la Candelaria
Mayaguez, PR 00682

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1356812168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 OESTE CALLE DE LA CANDELARIA",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00682",
            "telephone_number": "787-918-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 115 KM 24.6 BO ASOMANTE",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "787-589-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO RIVERA",
        "first_name": "KARINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9616T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "739-432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguada, PR

Sources for this page

Verify at the official NPI Registry.