Individual provider Active NPI

Jorge A Melendez, OD

  • Optometrist
  • Vega Baja, PR
National Provider Identifier
1871874750
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
707 Issued in PR
Practice address
P.R. - 2 KM 42.2
Barrio Algarrobo
Vega Baja, PR 00693
Phone
(787) 374-3925
NPI assigned
Sep 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270A00634100 NJ
Optometrist 152W00000X 707 PR Primary

Addresses

Primary practice location

P.R. - 2 KM 42.2
Barrio Algarrobo
Vega Baja, PR 00693

Mailing address

PO Box 270208
San Juan, PR 00928-3008
Phone (787) 374-3925

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
I20141119001545 PR Practitioner - Optometry 3678723392 Practice locations: Vega Baja, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270A00634100NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Melendez Gastroenterology Institute, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1871874750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270208",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009283008",
            "telephone_number": "787-374-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "P.R. - 2 KM 42.2",
            "address_2": "BARRIO ALGARROBO",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-374-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "JORGE",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00634100",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.