Individual provider Active NPI

Osvaldo Antonio Negron, O.D.

  • Pediatric Optometrist
  • Dorado, PR
National Provider Identifier
1770575946
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
DA2217 Issued in MD
Practice address
30002 Valle del Amanecer
Valle Dorado
Dorado, PR 00646
Phone
(787) 855-1414
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 417 PR
Pediatric Optometrist 152WP0200X DA2217 MD Primary
Pediatric Optometrist 152WP0200X 4901004515 MI

Addresses

Primary practice location

30002 Valle del Amanecer
Valle Dorado
Dorado, PR 00646

Mailing address

PO Box 2069
Bayamon, PR 00960-2069
Phone (787) 590-9014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20230324001068 MD Practitioner - Optometry 0446421903 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004515MIMDPediatric Optometrist
417PRMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Mar 10, 2023 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Mar 10, 2023 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients

Locations

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

10264 Southern Md Blvd
Ste 101
Dunkirk, MD 20754
Phone (410) 257-6931

920 Revolution St
Hvre de Grace, MD 21078
Phone (410) 939-2200

14700 Baltimore Ave
Unit 109
Laurel, MD 20707
Phone (301) 245-3903

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 3

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1770575946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2069",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009602069",
            "telephone_number": "787-590-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30002 VALLE DEL AMANECER",
            "address_2": "VALLE DORADO",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-855-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRON",
        "first_name": "OSVALDO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "PR",
            "license": "417",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MD",
            "license": "DA2217",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MI",
            "license": "4901004515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

Verify at the official NPI Registry.