Aoa Ophthalmic Group LLC

Organization Active NPI Ophthalmology Physician · Moca, PR

NPI 1972237410 · NPPES record last updated Jul 11, 2022

Key facts

NPI
1972237410
Entity type
Organization (NPI type 2)
Primary specialty
Ophthalmology Physician 207W00000X
Legal business name
AOA OPHTHALMIC GROUP LLC
Practice address
326 Calle Jesus Ramos
Moca, PR 00676-4576
Phone
(787) 463-6992
NPI assigned
Jul 11, 2022
Organization subpart
No

Authorized official

Name
Alberto Ortiz, MD
Title
President
Phone
(787) 463-6992

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
40D2269129Aoa Ophthalmic LLC
326 Calle Jesus Ramos, Moca, PR 00676
Certificate of waiverSep 20, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220826001770 PR Part B Supplier - Clinic/Group Practice 6103200050 Receives reassigned benefits from 1 practitioner
Practice locations: Moca, PR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207W00000X Yes
Ophthalmologic Surgery Clinic/Center 261QS0132X

Addresses

Primary practice location

326 Calle Jesus Ramos
Moca, PR 00676-4576

Mailing address

PO Box 85
Moca, PR 00676-0085
Phone (787) 463-6992

Other providers in Moca, PR

All providers in Moca, PR · Ophthalmology Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.