Individual provider Active NPI

Camille Marie Pacheco, OD

  • Optometrist
  • Guaynabo, PR
National Provider Identifier
1841330438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
518 Issued in PR
Practice address
San Patricio Plaza
Local A2
Guaynabo, PR 00968
Phone
(787) 749-0909
Fax
(787) 749-1213
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 518 PR Primary

Addresses

Primary practice location

San Patricio Plaza
Local A2
Guaynabo, PR 00968

Mailing address

11 Calle Principal
Urb. Suchville
Guaynabo, PR 00966-2028
Phone (787) 749-0909

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
I20130710000553 PR Practitioner - Optometry 0446490759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
518PRMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841330438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CALLE PRINCIPAL",
            "address_2": "URB. SUCHVILLE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662028",
            "telephone_number": "787-749-0909",
            "fax_number": "787-749-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN PATRICIO PLAZA",
            "address_2": "LOCAL A2",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "787-749-0909",
            "fax_number": "787-749-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "CAMILLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.