NPIMap

Organization Active NPI

Primary Medical Center, Inc

  • Emergency Care Clinic/Center
  • Ponce, PR
National Provider Identifier
1023574282
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
PRIMARY MEDICAL CENTER, INC
Practice address
Calle Mendez Vigo #24
Ponce, PR 00730-0000
Phone
(787) 848-3177
Fax
(787) 840-8874
NPI assigned
Feb 13, 2019
Last updated
Aug 26, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PRIMARY MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Authorized official

Name
Dr. Sergio Chevere Mourino, MDNPI 1528038973
Title
President
Phone
(787) 813-0257

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

Calle Mendez Vigo #24
Ponce, PR 00730-0000

Mailing address

PO Box 336149
Ponce, PR 00733-6149
Phone (787) 844-0331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150825003720 PR Part B Supplier - Clinic/Group Practice 5890001630 Receives reassigned benefits from 19 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yauco, PR; San Juan, PR; Ponce, PR; Jayuya, PR; Adjuntas, PR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Primary Medical Center Ipa8 organizations share this tax ID, including this one
Part of
Primary Medical Center Ipa

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1023574282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336149",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007336149",
            "telephone_number": "787-844-0331",
            "fax_number": "787-840-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE MENDEZ VIGO #24",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007300000",
            "telephone_number": "787-848-3177",
            "fax_number": "787-840-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY MEDICAL CENTER INC",
        "enumeration_date": "2019-02-13",
        "last_updated": "2020-08-26",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "CHEVERE MOURINO",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-813-0257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.