Individual provider Active NPI

Ilka E Rodriguez Menendez, OD

  • Optometrist
  • Gurabo, PR
National Provider Identifier
1376514331
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
157 Issued in PR
Practice address
100 Carr 189 Ste 7
Gurabo, PR 00778-8842
Phone
(787) 737-6393
Fax
(787) 712-5710
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000880 PR Practitioner - Optometry 9931267606 Practice locations: Gurabo, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
157PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

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

Verify at the official NPI Registry.