Individual provider Active NPI

Juan Adalberto Menjivar, O.D.

  • Optometrist
  • Ocala, FL
National Provider Identifier
1609025493
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4315 Issued in FL
Practice address
150 SE 17TH St Ste 100
Ocala, FL 34471
Phone
(352) 732-7900
Fax
(352) 732-7466
NPI assigned
Sep 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 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 OPC 4315 FL Primary

Addresses

Primary practice location

150 SE 17TH St Ste 100
Ocala, FL 34471

Mailing address

150 SE 17TH St Ste 100
Ocala, FL 34471-5177
Phone (352) 732-7900

Other practice location 1

1950 Laurel Manor Dr
Suite 250
The Villages, FL 32162-5603
Phone (352) 622-5183

Other practice location 2

1950 Laurel Manor Dr
Suite 250
The Villages, FL 32162-5603
Phone (352) 622-5183

Other identifiers 1

IdentifierTypeStateIssuer
1906LOtherFLBCBS FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100626000455 FL Practitioner - Optometry 2365573821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS Ritz and Johnson and Assoc. LLPGroup PAC ID 6507984440, 4 clinicians

Practice addresses (Care Compare)

150 SE 17TH St
Suite 100
Ocala, FL 34471-5177
Phone (352) 732-7900

150 SE 17TH St
Suite 100
Ocala, FL 34471-5188

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4315FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Ritz & Johnson & Assoc. LLP Optometrist CurrentSince May 1, 2014 Accepting new patients
Cards Opticians Inc PastSince Mar 1, 2011 Accepting new patients
Ocala Eye Optical, Inc. PastSince Jun 1, 2010 Accepting new patients

Locations

150 SE 17th St
Ste 100
Ocala, FL 34471
Phone (352) 732-7900

Organizations & group practices 3

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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1609025493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SE 17TH ST STE 100",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715177",
            "telephone_number": "352-732-7900",
            "fax_number": "352-732-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SE 17TH ST STE 100",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34471",
            "telephone_number": "352-732-7900",
            "fax_number": "352-732-7466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Laurel Manor Dr",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321625603",
            "country_code": "US",
            "telephone_number": "352-622-5183",
            "fax_number": "352-622-2720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 Laurel Manor Dr",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321625603",
            "country_code": "US",
            "telephone_number": "352-622-5183",
            "fax_number": "352-622-2720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENJIVAR",
        "first_name": "JUAN",
        "middle_name": "ADALBERTO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "1906L",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.