Organization Active NPI

Retina Care PSC

  • Ophthalmology Physician
  • Arecibo, PR
National Provider Identifier
1982958773
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16978 Issued in PR
Legal business name
RETINA CARE PSC
Practice address
58 Calle Ponce de Leon
Urb. Garcia
Arecibo, PR 00612-4315
Phone
(787) 680-7222
Fax
(787) 680-7223
NPI assigned
Nov 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Authorized official

Name
Dr. Andres Emanuelli Anzalotta, M.D.NPI 1023213154
Title
President
Phone
(787) 680-7222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 16978 PR Primary

Addresses

Primary practice location

58 Calle Ponce de Leon
Urb. Garcia
Arecibo, PR 00612-4315

Mailing address

PO Box 2770
Arecibo, PR 00613-2770
Phone (787) 680-7222

Other identifiers 1

IdentifierTypeStateIssuer
LIC MD 16978OtherPRLIC MD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140113001154 PR Part B Supplier - Clinic/Group Practice 0244468536 Receives reassigned benefits from 3 practitioners
Practice locations: Arecibo, PR; Corozal, PR

National Provider Directory

National Provider Directory

Locations

951 Carr 891
Ste 306
Corozal, PR 00783
Phone (787) 802-1335

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1982958773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2770",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006132770",
            "telephone_number": "787-680-7222",
            "fax_number": "787-680-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CALLE PONCE DE LEON",
            "address_2": "URB. GARCIA",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006124315",
            "telephone_number": "787-680-7222",
            "fax_number": "787-680-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "EMANUELLI  ANZALOTTA",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-680-7222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "16978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC MD",
            "identifier": "LIC MD 16978",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.