Modo Optico LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

MODO OPTICO LLC

Practice address

Suite 1B Calle 1 Ax-1 Pradera Norte
Urb Levittown
Toa Baja, PR 00949-9999

Phone

(939) 405-4799

NPI assigned

Feb 25, 2022

Organization subpart

No

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

Authorized official

Name

Monica Santiago

Title

President

Phone

(939) 405-4799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Tax ID family

Modo Optico LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Modo Optico LLC

  • Optician
  • Vega Alta, PR
  • NPI 1215689740
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brenda Marie Segarra Morales, OD

  • Optometrist
  • San Juan, PR
  • NPI 1386380087
  Medicare reassignment NPD

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1477209690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 URB LAS PALMAS DE CERRO GORDO",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "00692",
            "telephone_number": "939-405-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUITE 1B CALLE 1 AX-1 PRADERA NORTE",
            "address_2": "URB LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009499999",
            "telephone_number": "939-405-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODO OPTICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-01-16",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "939-405-4799"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa J Mir, BSN
• Helen Miranda Gonzalez
• Frances N Miranda
• Maria De Lourdes Miranda, MD
• MJ Therapy Services Corp.
• Michelle Marie Mojica, MSW
• Agnes Molina, RPH
• Freddy Molina
• Lourdes Cordero Molina, MS
• Madeline Molina, CPL

• Eyewear Supplier in Toa Baja, PR
• Providers in Toa Baja, PR by specialty
• Eyewear Supplier in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.