Advanced Retina LLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

ADVANCED RETINA LLC

Practice address

Calle Union #91 Esq Calle Sol
Ponce, PR 00730

Phone

(787) 848-5353

NPI assigned

Jul 1, 2022

Last updated

Jun 21, 2023By 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

Dr. Jan Carlos Ortiz Rosario, MDNPI 1386020709

Title

President

Phone

(787) 432-4849

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 3

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.

• Jan Carlos Ortiz Rosario, MD

  • Retina Specialist (Ophthalmology) Physician
  • Ponce, PR
  • NPI 1386020709
  Medicare reassignment NPD Authorized official
• Milton E Irizarry Quinones, MD

  • Ophthalmology Physician
  • Ponce, PR
  • NPI 1871500207
  NPD (past)
• Luis A Serrano, M. D.

  • Ophthalmology Physician
  • Ponce, PR
  • NPI 1235132713
  NPD (past)

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1871226415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7432",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327432",
            "telephone_number": "787-432-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE UNION #91 ESQ CALLE SOL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-848-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED RETINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "ORTIZ ROSARIO",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-432-4849",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Retina Specialist (Ophthalmology) Physician in Ponce, PR
• Providers in Ponce, PR by specialty
• Retina Specialist (Ophthalmology) Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.