Individual provider Active NPI

Grace M Wiley, O.D.

  • Optometrist
  • Caguas, PR
National Provider Identifier
1497805451
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
464 Issued in PR
Practice address
Carr.172 de Caguas a Cidra ; Urb. Turabo Gardens
Primer Piso, Hosptal Menonita Caguas
Caguas, PR 00725-0000
Phone
(787) 637-0834
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 464 PR Primary

Addresses

Primary practice location

Carr.172 de Caguas a Cidra ; Urb. Turabo Gardens
Primer Piso, Hosptal Menonita Caguas
Caguas, PR 00725-0000

Mailing address

423 Calle San Julian
Urb Sagrado Corazon
San Juan, PR 00926-4243
Phone (787) 637-0834

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
I20070515000363 PR Practitioner - Optometry 6305943069 Practice locations: Caguas, PR; San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hosp Menonita Caguas Carr
172 Urb Turabo Gardens
Caguas, PR 00725
Phone (787) 637-0834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
464PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoptical Optometrist Past 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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1497805451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 CALLE SAN JULIAN",
            "address_2": "URB SAGRADO CORAZON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264243",
            "telephone_number": "787-637-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR.172 DE CAGUAS A CIDRA ; URB. TURABO GARDENS",
            "address_2": "PRIMER PISO, HOSPTAL MENONITA CAGUAS",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007250000",
            "telephone_number": "787-637-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "GRACE",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.