Active NPI
Gloria Lopez, OD
- Optometrist
- San Juan, PR
National Provider Identifier
1497794721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 249
- Practice address
- JC Penney Optical , 4TH FL Jcpenney
Plaza Las Americas
San Juan, PR 00918 - Phone
- (787) 758-3080
- NPI assigned
- Jun 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 249 | PR | Primary |
Addresses
Primary practice location
JC Penney Optical , 4TH FL Jcpenney
Plaza Las Americas
San Juan, PR 00918
Mailing address
105 Camino Diaz Aponte
San Juan, PR 00926-9932
Phone (787) 344-3044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060306000181 | PR | Practitioner - General Practice | 4183630874 |
Reassigns benefits to 3 organizations 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Carolina, PR |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 249 | PR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686182400000",
"number": "1497794721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 CAMINO DIAZ APONTE",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009269932",
"telephone_number": "787-344-3044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JC PENNEY OPTICAL , 4TH FL JCPENNEY",
"address_2": "PLAZA LAS AMERICAS",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-758-3080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "GLORIA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2023-06-08",
"certification_date": "2023-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.