Stephanie Marie De La Matta, OD
NPI 1083210462ActiveIndividual· Optometrist· San German, PR
Optometrist (OD) in San German, Puerto Rico, licensed in PR, with an NPI issued in December 2020. Enrolled in Medicare as practitioner - optometry.
Overview
| NPI | 1083210462 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OD |
| Sole proprietor | Yes |
| NPI issued | Dec 10, 2020 |
| Last updated in NPPES | Dec 10, 2020 |
| Certified by provider | Dec 7, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 747 | PR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Optometry (PR) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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