Active NPI
Iliana Alvarado-Diaz, O.D.
- Optometrist
- Humacao, PR
National Provider Identifier
1972834547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 674
- Practice address
- 250 Calle Cruz Ortiz Stella Ste 11
Humacao, PR 00791-4144 - Phone
- (939) 428-1140
- Fax
- (877) 496-5503
- NPI assigned
- Jan 21, 2010
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 674 | PR | Primary |
Addresses
Primary practice location
250 Calle Cruz Ortiz Stella Ste 11
Humacao, PR 00791-4144
Mailing address
250 Calle Cruz Ortiz Stella Ste 11
Humacao, PR 00791-4144
Phone (787) 367-6238
Other practice location 1
615 Carr 152 Ste 3
Naranjito, PR 00719-3809
Phone (939) 319-7007
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120104000086 | PR | Practitioner - Optometry | 2466628086 | Practice locations: Humacao, PR; Naranjito, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 674 | PR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1972834547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 CALLE CRUZ ORTIZ STELLA STE 11",
"city": "HUMACAO",
"state": "PR",
"postal_code": "007914144",
"telephone_number": "787-367-6238",
"fax_number": "877-496-5503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 CALLE CRUZ ORTIZ STELLA STE 11",
"city": "HUMACAO",
"state": "PR",
"postal_code": "007914144",
"telephone_number": "939-428-1140",
"fax_number": "877-496-5503"
}
],
"practiceLocations": [
{
"address_1": "615 Carr 152 Ste 3",
"address_purpose": "LOCATION",
"city": "Naranjito",
"state": "PR",
"postal_code": "007193809",
"country_code": "US",
"telephone_number": "939-319-7007",
"fax_number": "877-496-5503",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALVARADO-DIAZ",
"first_name": "ILIANA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-21",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PR",
"license": "674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Humacao, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.