Luis E Mora-Antongiorgi, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

403-0029 Issued in PR

Practice address

525 Ave Roosevelt
Plaza Las Americas Lenscrafters 0474
San Juan, PR 00918

Phone

(787) 753-6431

Fax

(787) 753-0852

NPI assigned

Apr 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Western Visual Care PSC

  • Optometrist
  • Anasco, PR
  • NPI 1558629089
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1679793905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 AVE ARTERIAL B APT 2309",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-892-1218",
            "fax_number": "787-892-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 AVE ROOSEVELT",
            "address_2": "PLAZA LAS AMERICAS LENSCRAFTERS 0474",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-753-6431",
            "fax_number": "787-753-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA-ANTONGIORGI",
        "first_name": "LUIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "403-0029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038172400",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raul Fernando Montilla, D.M.D.
• Juan Ramon Montoyo Santiago, MD
• Mor Endocrine Care LLC
• Mor Medical Services
• Edna M Mora Pinero, MD
• Danny Mora-Gonzalez, DMD, MS
• Mayra Mora-Morales, MRC
• Myrna I Morales - Franqui, M.D.
• Liz Marie Morales Amador, RDN
• Frank Esteban Morales Barreto, M.D.

• Optometrist in San Juan, PR
• Providers in San Juan, PR by specialty
• Optometrist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.

Verify at the official NPI Registry.