Individual provider Active NPI

Terry Ann Rivera Rodriguez, OD

  • Optometrist
  • Caguas, PR
National Provider Identifier
1487716908
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
390 Issued in PR
Practice address
19 Street Y-18
Villa Nueva
Caguas, PR 00725
Phone
(787) 636-1835
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 390 PR Primary

Addresses

Primary practice location

19 Street Y-18
Villa Nueva
Caguas, PR 00725

Mailing address

19 Street #Y-18
Villa Nueva
Caguas, PR 00725
Phone (787) 636-1835

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
I20180611001109 PR Practitioner - Optometry 3476808734 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
390PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Vision Center LLC CurrentSince Aug 30, 2021 Accepting new patients
Elite Vision Center LLC PastSince May 4, 2025 Accepting new patients

Organizations & group practices 2

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1487716908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 STREET #Y-18",
            "address_2": "VILLA NUEVA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-636-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 STREET Y-18",
            "address_2": "VILLA NUEVA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-636-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA RODRIGUEZ",
        "first_name": "TERRY",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.