Individual provider Active NPI

Gabriel Rodriguez Quijano, O.D.

  • Optometrist
  • Quebadillas, PR
National Provider Identifier
1992767768
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
169 Issued in PR
Practice address
Road. #2 KM. 96.8 Bo. Cocos
Quebadillas, PR 00678
Phone
(787) 895-6197
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 169 PR Primary

Addresses

Primary practice location

Road. #2 KM. 96.8 Bo. Cocos
Quebadillas, PR 00678

Mailing address

PO Box 2272
Isabela, PR 00662-2003
Phone (787) 895-6197

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
I20110801000896 PR Practitioner - Optometry 6002085446 Practice locations: Quebradillas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
169PRMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1992767768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2272",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006622003",
            "telephone_number": "787-895-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROAD. #2 KM. 96.8 BO. COCOS",
            "city": "QUEBADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "telephone_number": "787-895-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ QUIJANO",
        "first_name": "GABRIEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.