Juan M Ortiz Colon Sr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

187 Issued in PR

Practice address

950 Carr 891 Ste 19
Corozal, PR 00783

Phone

(787) 859-7958

Fax

(787) 859-7958

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1376602508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 CARR 891 ST 19",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "00783",
            "telephone_number": "787-859-7958",
            "fax_number": "787-859-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CARR 891 STE 19",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "00783",
            "telephone_number": "787-859-7958",
            "fax_number": "787-859-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ COLON",
        "first_name": "JUAN",
        "middle_name": "M",
        "name_suffix": "Sr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660806855",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "58009",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "660444808",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optica Real LLC
• Brian Antonio Ortega Bernard, MD
• Miguel Angel Ortiz Bou, M.D.
• Osvaldo Miguel Ortiz Bou, MD
• Miguel Angel Ortiz Caldero, MD
• Ortiz Emergency LCC
• Ortiz Emergency Response LLC
• Juan Luis Ortiz Matos, MD
• Luis Juan Ortiz Matos
• Ortiz Medical Group

• Optometrist in Corozal, PR
• Providers in Corozal, PR by specialty
• Optometrist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.

Verify at the official NPI Registry.