Individual provider Active NPI

Eileen Marrero, O.D.

  • Optometrist
  • Carolina, PR
National Provider Identifier
1407884265
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
330 Issued in PR
Practice address
Carr #3 KM 12.3 Ave. 65 Infanteria
Carolina
Carolina, PR 00985
Phone
(787) 769-2477
Fax
(787) 276-0065
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 330 PR Primary

Addresses

Primary practice location

Carr #3 KM 12.3 Ave. 65 Infanteria
Carolina
Carolina, PR 00985

Mailing address

PO Box 190990 Hato Rey Station
San Juan Puerto Rico
San Juan, PR 00919-0990
Phone (787) 769-2477

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
I20120621000483 PR Practitioner - Optometry 5395909477 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
330PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Instituto de Ojos Y Piel CurrentSince May 20, 2012 Accepting new patients
Instituto de Ojos Y Piel, Inc Optometrist CurrentSince May 20, 2012 Accepting new patients
Instituto de Ojos Y Piel, Inc Past Accepting new patients

Locations

11310 Ave 65 Infanteria
#3
Carolina, PR 00987
Phone 7877692477325

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407884265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190990 HATO REY STATION",
            "address_2": "SAN JUAN PUERTO RICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009190990",
            "telephone_number": "787-769-2477",
            "fax_number": "787-276-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #3 KM 12.3 AVE. 65 INFANTERIA",
            "address_2": "CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-769-2477",
            "fax_number": "787-276-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "EILEEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.