Active NPI
Ivette Burgos-Irizarry, O.D.
- Optometrist
- Ponce, PR
National Provider Identifier
1942425319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 000325
- Practice address
- 2050 Ponce by Pass
Suite 101
Ponce, PR 00717 - Phone
- (787) 259-8882
- NPI assigned
- Apr 13, 2007
- Last updated
- Feb 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 000325 | PR | Primary |
Addresses
Primary practice location
2050 Ponce by Pass
Suite 101
Ponce, PR 00717
Mailing address
2050 Ponce by Pass
Plaza del Caribe Suite 101
Ponce, PR 00717
Phone (939) 717-0257
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-8111938 | Other | TAX ID# |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 325 | PR | MD | Nutritionist |
| 000325 | PR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Current | Accepting new patients | |
| Luxottica of America Inc. | Current | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
Locations
4000 Luxottica Pl
Mason, OH 45040
Phone (513) 765-2155
2050 Ponce Byp
Ste 101
Ponce, PR 00716
Phone (787) 259-8882
Organizations & group practices 3
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": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1942425319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 PONCE BY PASS",
"address_2": "PLAZA DEL CARIBE SUITE 101",
"city": "PONCE",
"state": "PR",
"postal_code": "00717",
"telephone_number": "939-717-0257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 PONCE BY PASS",
"address_2": "SUITE 101",
"city": "PONCE",
"state": "PR",
"postal_code": "00717",
"telephone_number": "787-259-8882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGOS-IRIZARRY",
"first_name": "IVETTE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "000325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID#",
"identifier": "20-8111938",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.