Individual provider Active NPI

Noemi Medina, O.D.

  • Optometrist
  • Villalba, PR
National Provider Identifier
1699214866
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
724 Issued in PR
Practice address
18 Calle Munoz Rivera
Villalba, PR 00766
Phone
(787) 847-1234
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 724 PR Primary

Addresses

Primary practice location

18 Calle Munoz Rivera
Villalba, PR 00766

Mailing address

E33 Calle 3
Urb El Madrigal
Ponce, PR 00730-1415

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
I20240805001982 PR Order and Referring Only - OptometryPractitioner - Optometry 2466728092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
724PRMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Salinas Optical Clinic Corporation Optometrist CurrentSince Jun 21, 2020 Accepting new patients
Clinica Visual Villalba Optometrist Past 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": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1699214866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E33 CALLE 3",
            "address_2": "URB EL MADRIGAL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007301415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CALLE MUNOZ RIVERA",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "00766",
            "telephone_number": "787-847-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "NOEMI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villalba, PR

Sources for this page

Verify at the official NPI Registry.