Active NPI
Moraima De Lourdes Negron, O.D.
- Optometrist
- San Juan, PR
National Provider Identifier
1669593067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 588
- Practice address
- 60 Calle Georgetti
Ste 1
San Juan, PR 00925-3607 - Phone
- (787) 765-0039
- Fax
- (787) 765-0039
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- 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 | 588 | PR | Primary |
Addresses
Primary practice location
60 Calle Georgetti
Ste 1
San Juan, PR 00925-3607
Mailing address
PO Box 192173
San Juan, PR 00919-2173
Phone (787) 505-1184
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 |
|---|---|---|---|---|
| I20240522002544 | PR | Practitioner - Optometry | 3779925789 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 588 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531785600000",
"number": "1669593067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 192173",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009192173",
"telephone_number": "787-505-1184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 CALLE GEORGETTI",
"address_2": "STE 1",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009253607",
"telephone_number": "787-765-0039",
"fax_number": "787-765-0039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEGRON",
"first_name": "MORAIMA",
"middle_name": "DE LOURDES",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2018-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "588",
"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 Jul 17, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.