Active NPI
Edrick Nieves Gonzalez
- Optician
- Mayaguez, PR
National Provider Identifier
1396087508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 155525
- Practice address
- 975 Ave Hostos
Suite 62
Mayaguez, PR 00680-1251 - Phone
- (787) 832-5540
- Fax
- (787) 832-5540
- NPI assigned
- Mar 26, 2013
- Last updated
- Mar 26, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 155525 | FL | Primary |
Addresses
Primary practice location
975 Ave Hostos
Suite 62
Mayaguez, PR 00680-1251
Mailing address
PO Box 3294
Mayaguez, PR 00681-3294
Phone (787) 501-4333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 155525 | FL | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edrick Nieves Gonzalez | Optician | Past | Accepting new patients |
Organizations & group practices 1
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": "1364256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1396087508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3294",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006813294",
"telephone_number": "787-501-4333",
"fax_number": "787-805-0288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 AVE HOSTOS",
"address_2": "SUITE 62",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006801251",
"telephone_number": "787-832-5540",
"fax_number": "787-832-5540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEVES GONZALEZ",
"first_name": "EDRICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-26",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "155525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mayaguez, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.