Active NPI
Lourdes Amparo Diaz, O.D.
- Optometrist
- San Juan, PR
National Provider Identifier
1710041918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 406
- Practice address
- 563 Trigo
El Dorado 5C
San Juan, PR 00907 - Phone
- (787) 722-0215
- Fax
- (787) 723-8783
- NPI assigned
- Dec 21, 2006
- 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 | 406 | PR | Primary |
Addresses
Primary practice location
563 Trigo
El Dorado 5C
San Juan, PR 00907
Mailing address
563 Trigo
El Dorado 5C
San Juan, PR 00907
Phone (787) 722-0215
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 |
|---|---|---|---|---|
| I20110812000483 | PR | Practitioner - Optometry | 4789853409 | Practice locations: San Juan, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 406 | PR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301529600000",
"number": "1710041918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "563 TRIGO",
"address_2": "EL DORADO 5C",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00907",
"telephone_number": "787-722-0215",
"fax_number": "787-723-8783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "563 TRIGO",
"address_2": "EL DORADO 5C",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00907",
"telephone_number": "787-722-0215",
"fax_number": "787-723-8783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "LOURDES",
"middle_name": "AMPARO",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2011-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "406",
"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 Mar 31, 2011; 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.