Ramon Edgardo Juan, O.D.
Individual provider Active NPI Optometrist · Anasco, PR
NPI 1952604209 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1952604209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 682 (PR)
- Practice address
- Carr 402 KM 4.6 Bo Pinales
Anasco, PR 00610 - Phone
- (787) 203-7611
- Fax
- (787) 229-1040
- NPI assigned
- Dec 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- International American University at Puerto Rico - School of Optometry, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2 Ave Castro Perez
San German, PR 00683-4484
Phone (787) 342-5161
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110506000034 | PR | Practitioner - Optometry | 8820273857 |
Reassigns benefits to 1 organization Practice locations: San German, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Consultorio Optometrico de SG, CSP | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 682 | PR | Yes |
Addresses
Primary practice location
Carr 402 KM 4.6 Bo Pinales
Anasco, PR 00610
Mailing address
PO Box 2540
San German, PR 00683-2540
Phone (787) 342-5161
Other practice location 1
25A Calle San Isidro
Sabana Grande, PR 00637-1853
Phone (787) 804-0536
Other practice location 2
2 Ave Angel Casto Perez
San German, PR 00683
Phone (787) 892-1218
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038327000 | Medicaid | PR | |
| 038327002 | Medicaid | PR | |
| 038327001 | Medicaid | PR |
Other providers in Anasco, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.