Active NPI
Ilka E Rodriguez Menendez, OD
- Optometrist
- Gurabo, PR
National Provider Identifier
1376514331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 157
- Practice address
- 100 Carr 189 Ste 7
Gurabo, PR 00778-8842 - Phone
- (787) 737-6393
- Fax
- (787) 712-5710
- NPI assigned
- Jan 30, 2006
- Last updated
- Aug 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 157 | PR | Primary |
Addresses
Primary practice location
100 Carr 189 Ste 7
Gurabo, PR 00778-8842
Mailing address
PO Box 203
Gurabo, PR 00778-0203
Phone (787) 737-6393
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 |
|---|---|---|---|---|
| I20081023000880 | PR | Practitioner - Optometry | 9931267606 | Practice locations: Gurabo, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 157 | PR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ilka Rodriguez, CRL | Optometrist | Past | Accepting new patients |
| Ilka Rodriguez | Optometrist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1376514331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 203",
"city": "GURABO",
"state": "PR",
"postal_code": "007780203",
"telephone_number": "787-737-6393",
"fax_number": "787-712-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CARR 189 STE 7",
"city": "GURABO",
"state": "PR",
"postal_code": "007788842",
"telephone_number": "787-737-6393",
"fax_number": "787-712-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ MENENDEZ",
"first_name": "ILKA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gurabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.