Individual provider Active NPI

Pedro Javier Migenes Varona, O.D.

  • Optometrist
  • Guaynabo, PR
National Provider Identifier
1730290628
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
563 Issued in PR
Practice address
31 Calle Carazo
Guaynabo, PR 00969-5708
Phone
(787) 720-7080
Fax
(787) 720-7080
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 563 PR Primary

Addresses

Primary practice location

31 Calle Carazo
Guaynabo, PR 00969-5708

Mailing address

31 Calle Carazo
Guaynabo, PR 00969-5708
Phone (787) 720-7080

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
I20241030004185 PR Practitioner - Optometry 3173056066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
563PRMDPhysical Therapist
000563PRMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1730290628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CALLE CARAZO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695708",
            "telephone_number": "787-720-7080",
            "fax_number": "787-720-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 CALLE CARAZO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695708",
            "telephone_number": "787-720-7080",
            "fax_number": "787-720-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIGENES VARONA",
        "first_name": "PEDRO",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.