Active NPI
Pedro David Salib, O.D.
- Optometrist
- Carolina, PR
National Provider Identifier
1619281094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 135
- Practice address
- Carolina Shopp Ctr
Ave. Fragoso, First Floor, Local 108
Carolina, PR 00985-5672 - Phone
- (787) 708-4444
- NPI assigned
- Jul 28, 2010
- 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 | 135 | PR | Primary |
Addresses
Primary practice location
Carolina Shopp Ctr
Ave. Fragoso, First Floor, Local 108
Carolina, PR 00985-5672
Mailing address
Las Flores de Montehiedra 300
Calle Romerillo Buzon 680
San Juan, PR 00926
Phone (787) 708-4444
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
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
200 Ave Fragoso
Suite 108
Carolina, PR 00983-3130
Phone (787) 768-6666
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E C Boutique Corp | Optometrist | Current | Accepting new patients |
| E C Boutique Corp | Optometrist | Past | Accepting new patients |
Locations
200 Ave Fragoso
Ste 108
Carolina, PR 00983
Phone (787) 286-0654
Organizations & group practices 2
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": "1280275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280275200000",
"number": "1619281094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LAS FLORES DE MONTEHIEDRA 300",
"address_2": "CALLE ROMERILLO BUZON 680",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-708-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CAROLINA SHOPP CTR",
"address_2": "AVE. FRAGOSO, FIRST FLOOR, LOCAL 108",
"city": "CAROLINA",
"state": "PR",
"postal_code": "009855672",
"telephone_number": "787-708-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALIB",
"first_name": "PEDRO",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-28",
"last_updated": "2010-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.