Ecb Humacao
NPI 1104604768ActiveOrganization· Optometrist· Fajardo, PR
Optometrist in Fajardo, Puerto Rico, registered in NPPES in September 2023, part of Ecb Humacao. The authorized official on file is Gabriel Santos, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104604768 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ecb Humacao |
| NPI issued | Sep 15, 2023 |
| Last updated in NPPES | Dec 17, 2025 |
| Certified by provider | Dec 17, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
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 Part B Supplier - Clinic/Group Practice (PR) |
|---|
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