Organization Active NPI

Nogal Visual Clinic Corp

  • Clinic/Center
  • Bayamon, PR
National Provider Identifier
1487071288
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
335093 Issued in PR
Legal business name
NOGAL VISUAL CLINIC CORP
Practice address
Urb Lomas Verdes
Nogal Ave 4X2
Bayamon, PR 00956
Phone
(787) 798-1315
Fax
(787) 780-5538
NPI assigned
Mar 19, 2014
Last updated
Feb 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Authorized official

Name
Dr. Mary Merced, ODNPI 1639177116
Title
President
Phone
(787) 798-1315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 335093 PR Primary

Addresses

Primary practice location

Urb Lomas Verdes
Nogal Ave 4X2
Bayamon, PR 00956

Mailing address

Urb Lomas Verdes
Nogal Ave 4X2
Bayamon, PR 00956
Phone (787) 798-1315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190208002267 PR Part B Supplier - Clinic/Group Practice 3678811031 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

4X2 Ave Nogal
Bayamon, PR 00956
Phone (787) 798-1315

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550188800000",
    "number": "1487071288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB LOMAS VERDES",
            "address_2": "NOGAL AVE 4X2",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-798-1315",
            "fax_number": "787-780-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB LOMAS VERDES",
            "address_2": "NOGAL AVE 4X2",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-798-1315",
            "fax_number": "787-780-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOGAL VISUAL CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2019-02-15",
        "status": "A",
        "authorized_official_last_name": "MERCED",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-798-1315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": "335093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.