Individual provider Active NPI

Glenda Damaris Santini Rodriguez

  • Optometrist
  • Bayamon, PR
National Provider Identifier
1477673192
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
448 Issued in PR
Practice address
Ave 830 KM0.1 Barrio Cerro Gordo
Bayamon, PR 00957
Phone
(787) 730-3653
Fax
(787) 730-9545
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 448 PR Primary

Addresses

Primary practice location

Ave 830 KM0.1 Barrio Cerro Gordo
Bayamon, PR 00957

Mailing address

Cond. Santa Ana Sur
Apt 20-a
Guaynabo, PR 00969
Phone (787) 238-0111

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
I20100506000460 PR Practitioner - Optometry 0749318012 Practice locations: Catano, PR; Cidra, PR; Guaynabo, PR; Salinas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
448PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tu Vision Opti K Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1477673192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND. SANTA ANA SUR",
            "address_2": "APT 20-A",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-238-0111",
            "fax_number": "787-763-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE 830 KM0.1 BARRIO CERRO GORDO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00957",
            "telephone_number": "787-730-3653",
            "fax_number": "787-730-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTINI RODRIGUEZ",
        "first_name": "GLENDA",
        "middle_name": "DAMARIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.