Omar A Camacho, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23028 Issued in PR

Practice address

Avenida General Valero #404
Fajardo
Fajardo, PR 00738

Phone

(787) 863-0505

Fax

(787) 655-5020

NPI assigned

Feb 16, 2022

Last updated

Sep 18, 2023By the provider in NPPES

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

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1689329807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URBANIZACION LA ESTANCIA",
            "address_2": "CALLE TAMARINDO #89",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "00777",
            "telephone_number": "787-484-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA GENERAL VALERO #404",
            "address_2": "FAJARDO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-863-0505",
            "fax_number": "787-655-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "OMAR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-16",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Willard Brewster III, M.D.
• Manuel A Cabrera Diaz, M.D.
• John Axel Cabrera Ramos
• Sharielys Enid Cabrera Suazo
• Glendali Camacho, RPH
• Yessi Caraballo, M.D.
• Pedro A. Carde, M.D.
• Caribbean Medical Supplies
• Caribe Pharmacy Management LLC (Farmacia Caridad #39)
• Caribe Physicians Plaza (Caribbean Medical Center)

• General Practice Physician in Fajardo, PR
• Providers in Fajardo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.