Individual provider Active NPI

Jose Ricardo Lopez, O.D.

  • Optometrist
  • San Sebastian, PR
National Provider Identifier
1922178128
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
349 Issued in PR
Practice address
281 Calle Ruiz Belvis
San Sebastian, PR 00685-2335
Phone
(787) 896-7040
Fax
(787) 896-7050
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 349 PR Primary

Addresses

Primary practice location

281 Calle Ruiz Belvis
San Sebastian, PR 00685-2335

Mailing address

281 Calle Ruiz Belvis
San Sebastian, PR 00685-2335
Phone (787) 896-7040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140212001469 TX Practitioner - Optometry 6901035062 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
349PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services CurrentSince Dec 4, 2013 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Dec 4, 2013 Accepting new patients
Yolanda Rodriguez Morales Past Accepting new patients
Ojos Centro Optico LLC Optometrist PastSince Jul 25, 2018 Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

107 H St
Poplar, MT 59255
Phone (406) 738-3491

Organizations & group practices 4

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1922178128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 CALLE RUIZ BELVIS",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006852335",
            "telephone_number": "787-896-7040",
            "fax_number": "787-896-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 CALLE RUIZ BELVIS",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006852335",
            "telephone_number": "787-896-7040",
            "fax_number": "787-896-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSE",
        "middle_name": "RICARDO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Sebastian, PR

Sources for this page

Verify at the official NPI Registry.