Individual provider Active NPI

Irma E Lopez - Soto, O.D.

  • Optometrist
  • Carolina, PR
National Provider Identifier
1861612038
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
317 Issued in PR
Practice address
Ave. Fragoso #14 Villa Fontana
Carolina, PR 00983
Phone
(787) 565-2155
NPI assigned
Apr 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 317 PR Primary

Addresses

Primary practice location

Ave. Fragoso #14 Villa Fontana
Carolina, PR 00983

Mailing address

PO Box 363749
San Juan, PR 00936-3749
Phone (787) 565-2155

Other identifiers 2

IdentifierTypeStateIssuer
58127LOOtherPRTRIPLE-S, INC
58127OtherPRMEDICARE OPTIMO TRIPLE-S

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
I20051128000154 PR Practitioner - Optometry 0345260071 Reassigns benefits to 1 organization
Practice locations: Cayey, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
317PRMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Optical Services & Management Group Inc CurrentSince Jan 11, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861612038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 363749",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009363749",
            "telephone_number": "787-565-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. FRAGOSO #14 VILLA FONTANA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983",
            "telephone_number": "787-565-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ - SOTO",
        "first_name": "IRMA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE-S, INC",
            "identifier": "58127LO",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OPTIMO  TRIPLE-S",
            "identifier": "58127",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.