Centro de Diagnostico Y Tratamiento Oftalmologico, Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

CENTRO DE DIAGNOSTICO Y TRATAMIENTO OFTALMOLOGICO, INC

Practice address

Ave de Diego 150
Suite 404
San Juan, PR 00907

Phone

(787) 725-9318

Fax

(787) 724-4654

NPI assigned

Dec 13, 2005

Last updated

Oct 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Maria H Berrocal Fernandez, MD

Title

President

Phone

(787) 725-9315

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria H Berrocal-Fernandez, MD

  • Ophthalmology Physician
  • San Juan, PR
  • NPI 1104800630
  Medicare reassignment NPD
• Vanessa Cruz-Villegas, M.D.

  • Ophthalmology Physician
  • San Juan, PR
  • NPI 1578614319
  NPD (past)
• Edgar Davila, O.D.

  • Low Vision Rehabilitation Optometrist
  • San Juan, PR
  • NPI 1457469959
  NPD (past)
• Jose R Montes, MD

  • Ophthalmology Physician
  • San Juan, PR
  • NPI 1518928498
  NPD (past)
• Virginia Rodriguez, M.D.

  • Ophthalmology Physician
  • Carolina, PR
  • NPI 1104907211
  NPD (past)
• Clarissa J De Paz, OD

  • Optometrist
  • Plano, TX
  • NPI 1013982198
  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1770568750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41281",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009401281",
            "telephone_number": "787-725-9315",
            "fax_number": "787-724-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE DE DIEGO 150",
            "address_2": "SUITE 404",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-725-9318",
            "fax_number": "787-724-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE DIAGNOSTICO Y TRATAMIENTO OFTALMOLOGICO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "MARIA H",
        "authorized_official_middle_name": "BERROCAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-725-9315",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28337",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Ophthalmology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.