Individual provider Active NPI

Jose N. Lugo, O.D.

  • Optometrist
  • Carolina, PR
National Provider Identifier
1396717716
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
153 Issued in PR
Practice address
10000 Ave 65 Infanteria Ste 112
Carolina Shopping Court
Carolina, PR 00985-5638
Phone
(787) 750-6705
Fax
(787) 762-3212
NPI assigned
Feb 2, 2006
Last updated
Dec 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 153 PR Primary

Addresses

Primary practice location

10000 Ave 65 Infanteria Ste 112
Carolina Shopping Court
Carolina, PR 00985-5638

Mailing address

10000 Ave 65 Infanteria Ste 112
Carolina Shopping Court
Carolina, PR 00985-5638
Phone (787) 750-6705

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
I20090225000072 PR Practitioner - Optometry 7719042894 Practice locations: Carolina, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
153PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jose N Lugo Dba Optometry World Carolina 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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1396717716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 AVE 65 INFANTERIA STE 112",
            "address_2": "CAROLINA SHOPPING COURT",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855638",
            "telephone_number": "787-750-6705",
            "fax_number": "787-762-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 AVE 65 INFANTERIA STE 112",
            "address_2": "CAROLINA SHOPPING COURT",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855638",
            "telephone_number": "787-750-6705",
            "fax_number": "787-762-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "JOSE",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.