Individual provider Active NPI

Reinaldo M Vazquez, OD

  • Optometrist
  • San German, PR
National Provider Identifier
1679629422
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
559 Issued in PR
Practice address
53 Calle Coral
Repto Pueblo Nuevo
San German, PR 00683-4306
Phone
(787) 264-4431
Fax
(787) 833-9200
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 559 PR Primary

Addresses

Primary practice location

53 Calle Coral
Repto Pueblo Nuevo
San German, PR 00683-4306

Mailing address

53 Calle Coral
Repto Pueblo Nuevo
San German, PR 00683-4306
Phone (787) 264-4431

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170825002490 PR Practitioner - Optometry 3678845666 Practice locations: San German, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tu Optica En San German Current Accepting new patients
Tu Optica Dr. Reinaldo Manolo Vazquez PastSince Apr 26, 2020 Accepting new patients

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679629422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CALLE CORAL",
            "address_2": "REPTO PUEBLO NUEVO",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006834306",
            "telephone_number": "787-264-4431",
            "fax_number": "787-833-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 CALLE CORAL",
            "address_2": "REPTO PUEBLO NUEVO",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006834306",
            "telephone_number": "787-264-4431",
            "fax_number": "787-833-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "REINALDO",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.