Organization Active NPI

Optometrics PSC

  • Optometrist
  • San Juan, PR
National Provider Identifier
1497871735
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
193 Issued in PR
Legal business name
OPTOMETRICS PSC
Practice address
369 Ave Domenech # B
San Juan, PR 00918-3708
Phone
(787) 754-0814
Fax
(787) 756-5823
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Authorized official

Name
Dr. Carmen Maria Suarez, OD
Title
Optometrist
Phone
(787) 754-0814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 193 PR Primary

Addresses

Primary practice location

369 Ave Domenech # B
San Juan, PR 00918-3708

Mailing address

369 Ave Domenech # B
San Juan, PR 00918-3708
Phone (787) 754-0814

Other identifiers 1

IdentifierTypeStateIssuer
56757OPOtherPRTRIPLE-S

Other names 1

  • puerto rico low vision center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091130000555 PR Part B Supplier - Clinic/Group Practice 9234278581 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

369 Calle Manuel Domenech
San Juan, PR 00918
Phone (787) 754-0814

369 Ave Domenech
#B
San Juan, PR 00918
Phone (787) 754-0814

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1497871735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 AVE DOMENECH # B",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183708",
            "telephone_number": "787-754-0814",
            "fax_number": "787-756-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 AVE DOMENECH # B",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183708",
            "telephone_number": "787-754-0814",
            "fax_number": "787-756-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRICS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "SUAREZ",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "787-754-0814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "PR",
            "license": "193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE-S",
            "identifier": "56757OP",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "puerto rico low vision center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 23, 2009; 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.