Individual provider Active NPI

Jennifer Ortiz Melendez, O.D.

  • Optometrist
  • Ponce, PR
National Provider Identifier
1962786038
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
684 Issued in PR
Practice address
8169 Calle Concordia
Condominio San Vicente Suite 204
Ponce, PR 00717
Phone
(787) 259-1111
Fax
(787) 259-1111
NPI assigned
Oct 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 684 PR Primary

Addresses

Primary practice location

8169 Calle Concordia
Condominio San Vicente Suite 204
Ponce, PR 00717

Mailing address

PO Box 303
Mercedita, PR 00715-0303
Phone (787) 412-7822

Other practice location 1

623 Yauco Plaza II
Yauco, PR 00698-4448
Phone (787) 267-6042

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
I20121107000044 PR Practitioner - Optometry 6305097064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
684PRMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ortiz Optometric Care Optometrist CurrentSince Jun 7, 2018 Accepting new patients
Family Optical Center Inc. Past Accepting new patients
Family Optical Center Inc. PastSince Aug 31, 2018 Accepting new patients

Locations

8169 Calle Concordia
Ste 204
Ponce, PR 00717
Phone (787) 259-1111

8118 Calle Concordia
Ste 201
Ponce, PR 00717
Phone (787) 259-1111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1962786038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 303",
            "city": "MERCEDITA",
            "state": "PR",
            "postal_code": "007150303",
            "telephone_number": "787-412-7822",
            "fax_number": "787-259-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8169 CALLE CONCORDIA",
            "address_2": "CONDOMINIO SAN VICENTE SUITE 204",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "787-259-1111",
            "fax_number": "787-259-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "623 Yauco Plaza II",
            "address_purpose": "LOCATION",
            "city": "Yauco",
            "state": "PR",
            "postal_code": "006984448",
            "country_code": "US",
            "telephone_number": "787-267-6042",
            "fax_number": "787-267-6042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTIZ MELENDEZ",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.