Individual provider Active NPI

Guillermo Pico-Alonso, MD

  • Ophthalmology Physician
  • Hato Rey, PR
National Provider Identifier
1851381305
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4642 Issued in PR
Practice address
Ave Ponce de Leon #715 Pda 37 1/2
Hato Rey, PR 00919-1227
Phone
(787) 409-4275
NPI assigned
Oct 26, 2005
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4642 PR Primary

Addresses

Primary practice location

Ave Ponce de Leon #715 Pda 37 1/2
Hato Rey, PR 00919-1227

Mailing address

103 Ave de Diego Apt 2104S
San Juan, PR 00911-3523
Phone (787) 409-4275

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090507000322 PR Practitioner - Ophthalmology 3476601162 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Puerto Rico School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Ponce de Leon Ave
San Juan, PR 00918
Phone (787) 409-4275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1851381305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 AVE DE DIEGO APT 2104S",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009113523",
            "telephone_number": "787-409-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE PONCE DE LEON #715 PDA 37 1/2",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "009191227",
            "telephone_number": "787-409-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICO-ALONSO",
        "first_name": "GUILLERMO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2024-06-06",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "4642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hato Rey, PR

Sources for this page

Verify at the official NPI Registry.