Organization Active NPI

Eye Care of San Juan P S C

  • Ophthalmology Physician
  • San Juan, PR
National Provider Identifier
1659689875
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
9085 Issued in PR
Legal business name
EYE CARE OF SAN JUAN P S C
Practice address
357 Ave de la Constitucion
Puerta de Tierra
San Juan, PR 00901-2208
Phone
(787) 289-6600
Fax
(787) 289-6622
NPI assigned
Sep 22, 2010
Organization subpart
Yes
Parent organization
EYE CARE OF SAN JUAN P S CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Lolita Delatorre
Title
Administrator
Phone
(787) 289-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 9085 PR Primary

Addresses

Primary practice location

357 Ave de la Constitucion
Puerta de Tierra
San Juan, PR 00901-2208

Mailing address

PO Box 13953
San Juan, PR 00908-3953
Phone (787) 289-6600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110811000349 PR Part B Supplier - Clinic/Group Practice 1355510199 Receives reassigned benefits from 2 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Part of
Eye Care of San Juan P S C

Locations

357 Ave de la Constitucion
San Juan, PR 00901
Phone (787) 289-6600

Practitioners & affiliated clinicians

Practitioners 2

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": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1659689875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13953",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009083953",
            "telephone_number": "787-289-6600",
            "fax_number": "787-289-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 AVE DE LA CONSTITUCION",
            "address_2": "PUERTA DE TIERRA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009012208",
            "telephone_number": "787-289-6600",
            "fax_number": "787-289-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE OF SAN JUAN P S C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CARE OF SAN JUAN P S C",
        "enumeration_date": "2010-09-22",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "DELATORRE",
        "authorized_official_first_name": "LOLITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-289-6600"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "9085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 3, 2011; 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.