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DR. KAREN MONTALVO-SEPULVEDA OD
NPI 1003119355
Optometrist in Aguadilla, PR

Active since December 08, 2010PECOS Enrolled
AGUADILLA MALL, # 39, AGUADILLA, PR 00603(787) 882-0078 Get Directions Write a Review

NPPES record last updated: May 22, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Karen Montalvo-sepulveda Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KAREN MONTALVO-SEPULVEDA OD (NPI 1003119355) is an individual optometrist in Aguadilla, Puerto Rico, licensed in Puerto Rico (683) and active in the NPI registry since December 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003119355
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. KAREN MONTALVO-SEPULVEDACredential: OD
Location AddressAGUADILLA MALL, # 39Aguadilla, PR 00603
Mailing AddressA6 Calle Cipres, Urb. FlamboyanMayaguez, PR 00680-1860 · (787) 617-6204
Phone(787) 882-0078
Sole ProprietorYes
Enumeration DateDecember 8, 2010
Last NPPES UpdateMay 22, 2018
✔ NPI 1003119355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in PR · 683
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Karen Montalvo-sepulveda Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Karen Montalvo-sepulveda reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

J & f Optical Service Incorporated
Optometrist
B275 CARR 693, DORAMAR PLAZA
Dorado, PR 00646
  • Reassigned Medicare billing, Puerto Rico enrollment
  • 5 clinicians in this Medicare group
NPI 1265978852 (787) 980-8008
M & m Optical Shop Corp
Optometrist
1900 AVE J T PINERO, ALTAMIRA XTRA SHOPPING CENTER
San Juan, PR 00921
  • Reassigned Medicare billing, Puerto Rico enrollment
  • 8 clinicians in this Medicare group
NPI 1760465066 (787) 782-2175

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 00603 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.65 typical visit price
range $56.86 – $172.44
Typical copayment $32.66 (range $14.21 – $43.11)
Most-billed visit code 99204
Established Patient
$70.88 typical visit price
range $18.24 – $140.44
Typical copayment $17.72 (range $4.56 – $35.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAUL CRUZ DETRES O.D.
Optometrist
AGUADILLA MALL
AGUADILLA, PR 00603
Aguadilla Municipio (787) 882-0077
ALVIN PEREZ-VALLE O.D.
Optometrist
AGUADILLA MALL, LOCAL #39
AGUADILLA, PR 00603
Aguadilla Municipio (787) 882-0077

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Karen Montalvo-sepulveda's NPI number?

The NPI number for Karen Montalvo-sepulveda is 1003119355. It was assigned to this individual provider in the NPPES registry on December 8, 2010.

Where is Karen Montalvo-sepulveda located?

Karen Montalvo-sepulveda practices at Aguadilla Mall # 39, Aguadilla, PR 00603. The listed phone number is (787) 882-0078.

What is Karen Montalvo-sepulveda's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Karen Montalvo-sepulveda enrolled in Medicare?

Yes. Karen Montalvo-sepulveda is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Karen Montalvo-sepulveda's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Karen Montalvo-sepulveda reassigns Medicare benefits to 2 organizations: J & f Optical Service Incorporated (Dorado, PR) and M & m Optical Shop Corp (San Juan, PR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Karen Montalvo-sepulveda's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Karen Montalvo-sepulveda accept?

Health plans from Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana list Karen Montalvo-sepulveda as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Karen Montalvo-sepulveda was last updated on May 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.