Individual provider Active NPI

Gabriela Maldonado Torres, OD

  • Optometrist
  • Villalba, PR
National Provider Identifier
1740943638
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
755 Issued in PR
Practice address
Clinica Visual Villalba
#31 Calle Luis Munoz Rivera
Villalba, PR 00766
Phone
(787) 847-1234
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 755 PR Primary

Addresses

Primary practice location

Clinica Visual Villalba
#31 Calle Luis Munoz Rivera
Villalba, PR 00766

Mailing address

Clinica Visual Villalba
#31 Calle Luis Muoz Rivera
Villalba, PR 00766
Phone (787) 847-1234

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
I20220120002223 PR Practitioner - Optometry 8921490137 Reassigns benefits to 1 organization
Practice locations: Villalba, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
755PRMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
GMT Eyecare Professional Optometrist CurrentSince Sep 23, 2021 Accepting new patients

Locations

31 Calle Munoz Rivera
Villalba, PR 00766
Phone (787) 847-1234

Organizations & group practices 1

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740943638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLINICA VISUAL VILLALBA",
            "address_2": "#31 CALLE LUIS MUOZ RIVERA",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "00766",
            "telephone_number": "787-847-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLINICA VISUAL VILLALBA",
            "address_2": "#31 CALLE LUIS MUNOZ RIVERA",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "00766",
            "telephone_number": "787-847-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO TORRES",
        "first_name": "GABRIELA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2022-07-21",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villalba, PR

Sources for this page

Verify at the official NPI Registry.