Individual provider Active NPI

Ruth M Ortiz Gonzalez, OPTOMETRIST

  • Optometrist
  • San Juan, PR
National Provider Identifier
1376721696
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
00456 Issued in PR
Practice address
Calle Emanuelli S # 215
Urb Davila Y Llenza
San Juan, PR 00917-4100
Phone
(787) 603-3601
NPI assigned
Feb 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 00456 PR Primary

Addresses

Primary practice location

Calle Emanuelli S # 215
Urb Davila Y Llenza
San Juan, PR 00917-4100

Mailing address

215 Calle Emanuelli S
Urb Davila Y Llenza
San Juan, PR 00917-4103
Phone (787) 603-3601

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
I20091119000630 PR Practitioner - Optometry 3678612272 Practice locations: Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00456PRMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1376721696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CALLE EMANUELLI S",
            "address_2": "URB DAVILA Y LLENZA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009174103",
            "telephone_number": "787-603-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE EMANUELLI S # 215",
            "address_2": "URB DAVILA Y LLENZA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009174100",
            "telephone_number": "787-603-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ GONZALEZ",
        "first_name": "RUTH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "00456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.