Individual provider Active NPI

Juan Everardo Cerda, O.D.

  • Optometrist
  • McAllen, TX
National Provider Identifier
1376510404
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05382TG Issued in TX
Practice address
317 S Broadway St
McAllen, TX 78501-4801
Phone
(956) 686-7435
Fax
(956) 686-6956
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 05382TG TX Primary

Addresses

Primary practice location

317 S Broadway St
McAllen, TX 78501-4801

Mailing address

1313 S Cage Blvd
Pharr, TX 78577-6227
Phone (956) 783-5500

Other identifiers 1

IdentifierTypeStateIssuer
041908701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20041028000752 TX Practitioner - Optometry 3870555204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1313 S Cage Blvd
Pharr, TX 78577-6227
Phone (956) 783-5500

317 S Broadway St
McAllen, TX 78501-4801
Phone (956) 686-7435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05382TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridge Eye Clinic & Optical Inc Optometrist CurrentSince Jan 15, 2001 Accepting new patients
Dr. Beardsley'S Super Optical, Inc. CurrentSince Nov 4, 2005 Accepting new patients

Locations

317 S Broadway St
McAllen, TX 78501
Phone (956) 686-7435

1313 S Cage Blvd
Pharr, TX 78577
Phone (956) 783-5500

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1376510404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 S CAGE BLVD",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785776227",
            "telephone_number": "956-783-5500",
            "fax_number": "956-783-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 S BROADWAY ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785014801",
            "telephone_number": "956-686-7435",
            "fax_number": "956-686-6956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERDA",
        "first_name": "JUAN",
        "middle_name": "EVERARDO",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05382TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041908701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.