Active NPI
Marilia Morales Gratacos, OD
- Optometrist
- San Juan, PR
National Provider Identifier
1366581340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 643
- Practice address
- 525 Roosevelt Ave
San Juan, PR 00918-8001 - Phone
- (787) 296-3922
- Fax
- (787) 296-3902
- NPI assigned
- Feb 6, 2007
- Last updated
- Feb 21, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 643 | PR | Primary |
Addresses
Primary practice location
525 Roosevelt Ave
San Juan, PR 00918-8001
Mailing address
PO Box 21099
San Juan, PR 00928-1099
Phone (787) 767-0436
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200817001344 | PR | Practitioner - Optometry | 1153747563 | Practice locations: Carolina, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 643 | PR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PR Vision Inc | Past | Accepting new patients |
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.
-
- Optician
- Carolina, PR
- NPI 1356619746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1366581340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21099",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009281099",
"telephone_number": "787-767-0436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 ROOSEVELT AVE",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009188001",
"telephone_number": "787-296-3922",
"fax_number": "787-296-3902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORALES GRATACOS",
"first_name": "MARILIA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
- Blanca Adianez Morales Cruz, OTL 1273
- Jennifer Morales Cruz, PHD
- Antonio Luis Morales Fernandez
- Carmen Morales Ferrer, MD
- Melissa Annette Morales Garcia, MD
- Elizabeth Morales Jimenez, PHD
- Efrain Morales Leon
- Arelis Nicole Morales Malave
- Jeannette Morales Marrero, MD
- Gianni Alexander Morales Martinez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.