HPM Foundation Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · San Juan, PR
NPI 1023730504 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1023730504
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- HPM FOUNDATION INC
- Practice address
- 1400 Calle Dover
Caparra Terrace
San Juan, PR 00920-5020 - Phone
- (787) 705-6771
- Fax
- (787) 919-3956
- NPI assigned
- Sep 13, 2022
- Organization subpart
- No
Authorized official
- Name
- Mrs. Ivonne I Rivera
- Title
- Ceo
- Phone
- (787) 268-4171
Other NPIs on the same Medicare enrollment 7
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 16
Practitioners 23
-
Ivonne V Acevedo, O.D.
-
Juan Manuel Roman-Vega, M.D.
-
Marcos E. Velez, M.D.
-
Limary Cordero Rivera, M.D.
-
Edwin E Pagan Lopez, M.D.
-
Jessica Rosario, M.D.
-
Octavio Santiago Santana, M.D.
-
Grissel Munoz Vargas, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PR
Federally qualified health center certification: CCN 401001
- Legal name
- HPM FOUNDATION INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 14, 2023
- Last certification
- Sep 14, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 14, 2012 in PR
- Enrollment address
- 1400 Calle Dover
San Juan, PR 9205020
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Ivonne Rivera Hernandez |
Corporate Director |
Jun 1, 2016 | |
| W-2 Managing Employee |
Sep 14, 2023 | ||
| Robert Cabello |
Corporate Director |
Jun 1, 2022 | |
| W-2 Managing Employee |
Sep 14, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100406000251 | PR | Part B Supplier - Clinic/Group Practice | 3870629579 |
Receives reassigned benefits from 65 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Carolina, PR; Culebra, PR; Guaynabo, PR; San Juan, PR; Vieques, PR |
| O20230915001367 | PR | Part a Provider - Federally Qualified Health Center (FQHC) | 3870629579 | Practice locations: San Juan, PR |
National Provider Directory
- Tax ID family
- HPM Foundation Clinical Laboratory
Locations
1400 Calle Dover
San Juan, PR 00920
Phone (787) 705-6771
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
1400 Calle Dover
Caparra Terrace
San Juan, PR 00920-5020
Mailing address
PO Box 14457
San Juan, PR 00916-4457
Phone (787) 268-4171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 039518100 | Medicaid | PR |
Other names
- HEALTHPROMED
Other providers in San Juan, PR
- Hospital Industrial
- Hospital Universitario de Adultos
- Hospital Universitario de Adultos
- Hoy Doc PR LLC
- Guillermo J Hoyos Precssas
- HPM Foundation Inc
- HPM Foundation Inc
- HPM Foundation Inc
- HPM Foundation Inc
- HPM Foundation Inc
All providers in San Juan, PR · Federally Qualified Health Center (FQHC) in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.