Organization Active NPI

Galeria Veinte Veinte LLC

  • Optometrist
  • Cabo Rojo, PR
National Provider Identifier
1942895529
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GALERIA VEINTE VEINTE LLC
Practice address
Marginal Carr. 100, KM 5.8
Cabo Rojo, PR 00623
Phone
(787) 235-2240
NPI assigned
Mar 4, 2021
Last updated
Mar 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Dr. Danica Ortiz, O.D.
Title
President/Optometrist
Phone
(787) 235-2240

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

Marginal Carr. 100, KM 5.8
Cabo Rojo, PR 00623

Mailing address

PO Box 1192
Hormigueros, PR 00660-1192
Phone (787) 235-2240

Other identifiers 1

IdentifierTypeStateIssuer
038245900MedicaidPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251124000943 PR Part B Supplier - Clinic/Group Practice 3678065075 Receives reassigned benefits from 1 practitioner
Practice locations: Cabo Rojo, PR

National Provider Directory

National Provider Directory

Locations

2320 Carr 100
Cabo Rojo, PR 00623
Phone (787) 254-6621

2320 Carr 100
Ste 101
Cabo Rojo, PR 00623
Phone (787) 254-6621

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1942895529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1192",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006601192",
            "telephone_number": "787-235-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARGINAL CARR. 100, KM 5.8",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "787-235-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALERIA VEINTE VEINTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-02-14",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "DANICA",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "787-235-2240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038245900",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabo Rojo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.