NPIMap

Organization Active NPI

Hospicio la Guadalupe Inc

  • Community Based Hospice Care Agency
  • Ponce, PR
National Provider Identifier
1023011376
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOSPICIO LA GUADALUPE INC
Practice address
Carr #14
Anexo Hosp Oncologico
Ponce, PR 00732-0000
Phone
(787) 259-8210
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Luz M Gonzalez
Title
Administrator
Phone
(787) 259-8210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

Carr #14
Anexo Hosp Oncologico
Ponce, PR 00732-0000

Mailing address

PO Box 7699
Ponce, PR 00732-7699
Phone (787) 259-8210

Other identifiers 2

IdentifierTypeStateIssuer
8400008OtherPRHUMANA
17185OtherPRTRIPLE C INC.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130308000217 PR Part A Provider - Hospice 0547415960 Practice locations: Ponce, PR

Hospice certification: CCN 401548

Legal name
HOSPICIO LA GUADALUPE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 21, 1994
Last certification
Oct 27, 2021
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Oct 21, 1994 in PR
Enrollment address
1266 Ave Hostos
Ponce, PR 00717-0947

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospicio la Guadalupe IncCCN 401548
Ownership
Other
Certified
Oct 21, 1994
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1266 Ave Hostos
Ponce, PR 00717
Phone (787) 813-2324

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jacqueline Rodriguez Rivera Individual Corporate DirectorBoard Treasurer Oct 1, 2023
W-2 Managing EmployeeFinancial Director Jun 1, 2015
Yolanda Santos Feliciano Individual Corporate OfficerBoard of Director Secretary Dec 15, 2023
W-2 Managing EmployeeAdministrative Assistance Jun 1, 2000
Edith M Rivera Ramos Individual Corporate DirectorBoard Member Director Oct 1, 2023
Vanessa Santiago Ramos Individual Corporate DirectorBoard Member Director Oct 1, 2023
Arleen Cruz Santiago Individual W-2 Managing EmployeeBilling Officer Feb 26, 2001
Rafael O Mendoza Rodriguez Individual Corporate DirectorBoard of Directors President Oct 1, 2023
W-2 Managing EmployeeMD; Jan 2, 2015
Operational/Managerial ControlMedical Director Jan 2, 2015
Ronaldo Rosado Rubio Individual W-2 Managing EmployeeAd; Jul 1, 2001 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023011376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7699",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327699",
            "telephone_number": "787-259-8210",
            "fax_number": "787-259-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #14",
            "address_2": "ANEXO HOSP ONCOLOGICO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007320000",
            "telephone_number": "787-259-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICIO LA GUADALUPE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-259-8210",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "8400008",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE C INC.",
            "identifier": "17185",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.