Active NPI
Gonzalo Cardona-Irizarry, O.D.
- Optometrist
- Manati, PR
National Provider Identifier
1609956424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 305
- Practice address
- 11 Ave Colon
Manati, PR 00674-4961 - Phone
- (787) 884-4372
- Fax
- (787) 884-8714
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 305 | PR | Primary |
Addresses
Primary practice location
11 Ave Colon
Manati, PR 00674-4961
Mailing address
PO Box 881
Manati, PR 00674-0881
Phone (787) 884-4372
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121109000528 | PR | Practitioner - Optometry | 3476704990 | Practice locations: Baceloneta, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- International American University at Puerto Rico - School of Optometry, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
140 Carr 2 KM 54
Baceloneta, PR 00617
Phone (787) 846-8765
Premium Outlets Carribean Cenimas
Carr 2 KM 54.6 Interseccion 140 Bo. Mana
Barcelonta, PR 00617-2808
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305 | PR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609956424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 881",
"city": "MANATI",
"state": "PR",
"postal_code": "006740881",
"telephone_number": "787-884-4372",
"fax_number": "787-884-8714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 AVE COLON",
"city": "MANATI",
"state": "PR",
"postal_code": "006744961",
"telephone_number": "787-884-4372",
"fax_number": "787-884-8714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDONA-IRIZARRY",
"first_name": "GONZALO",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manati, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.