Individual provider Active NPI

Brenda Marie Segarra Morales, OD

  • Optometrist
  • San Juan, PR
National Provider Identifier
1386380087
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
758 Issued in PR
Practice address
Lens Vision 100 Grand Blvd
Suite 116
San Juan, PR 00976
Phone
(787) 755-1414
NPI assigned
May 6, 2022
Last updated
May 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 758 PR Primary

Addresses

Primary practice location

Lens Vision 100 Grand Blvd
Suite 116
San Juan, PR 00976

Mailing address

Urb. Rio Cristal Via Amazonas
RJ6
Trujillo Alto, PR 00976
Phone (787) 424-5724

Other practice location 1

Lens Vision PR-137
Vega Baja, PR 00693
Phone (787) 424-5724

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
I20220707003952 PR Practitioner - Optometry 5799165767 Reassigns benefits to 2 organizations
Practice locations: Vega Alta, PR; Vega Baja, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Modo Optico LLC CurrentSince Jan 4, 2025 Accepting new patients
Vision Outlet LLC CurrentSince Apr 5, 2024 Accepting new patients
Modo Optico LLC PastSince Feb 1, 2022 Accepting new patients

Locations

5 Calle Dufresne E
Humacao, PR 00791
Phone (787) 433-9006

AA2 Ave Tejas
Humacao, PR 00791
Phone (787) 530-8966

AX1 Calle 1
Toa Baja, PR 00949
Phone (787) 509-1234

Organizations & group practices 3

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": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1386380087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. RIO CRISTAL VIA AMAZONAS",
            "address_2": "RJ6",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-424-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LENS VISION 100 GRAND BLVD",
            "address_2": "SUITE 116",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-755-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Lens Vision PR-137",
            "address_purpose": "LOCATION",
            "city": "Vega Baja",
            "state": "PR",
            "postal_code": "00693",
            "country_code": "US",
            "telephone_number": "787-424-5724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGARRA MORALES",
        "first_name": "BRENDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.