Active NPI
Servicios Suplementarios de Salud, Inc.
- Community Based Hospice Care Agency
- Hato Rey, PR
National Provider Identifier
1043324874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 12
- Legal business name
- SERVICIOS SUPLEMENTARIOS DE SALUD, INC.
- Practice address
- 114 Eleanor Roosevelt St.
Urb. El Vedado
Hato Rey, PR 00918 - Phone
- (787) 780-4010
- Fax
- (787) 787-5787
- NPI assigned
- Aug 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Carmen M Martino, RN MSN
- Title
- Executive Director
- Phone
- (787) 753-8095
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 12 | PR | Primary |
Addresses
Primary practice location
114 Eleanor Roosevelt St.
Urb. El Vedado
Hato Rey, PR 00918
Mailing address
114 Eleanor Roosevelt St.
Urb. El Vedado
Hato Rey, PR 00918
Phone (787) 759-7035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081021000414 | PR | Part A Provider - Hospice | 7012075062 | Practice locations: Bayamon, PR; Camuy, PR; Fajardo, PR; Juana Diaz, PR; San Juan, PR; San Lorenzo, PR |
Hospice certification: CCN 401529
- Legal name
- SERVICIOS SUPLEMENTARIOS DE SALUD, INC.
- Doing business as
- HOSPICIO GREGORIA AUFFANT INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jan 15, 1993
- Last certification
- Feb 25, 2021
- Ownership / control type
- Non-Profit - Private
- Organization structure
- Corporation
- Incorporated
- Sep 28, 1992 in PR
- Enrollment address
- 114 Eleanor Roosevelt
2ND Floor
San Juan, PR 00918-3105
Care Compare: Hospice
Medicare Care Compare- Listed as
- Hospicio Gregoria Auffant Inc
- Ownership
- For-Profit
- Certified
- Jan 15, 1993
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Farmacia Gregoria Auffant
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Bayamon, PR
- NPI 1053561712
Locations
121 Calle Atenas
#1
Bayamon, PR 00959
Phone (787) 780-4111
53 Ave Munoz Rivera E
Ste 3
Camuy, PR 00627
Phone (787) 262-5321
57 Calle Celis Aguilera S
#A
Fajardo, PR 00738
Phone (787) 863-1147
155 Calle Munoz Rivera S
San Lorenzo, PR 00754
Phone (787) 736-5200
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Patzulivia Figueroa Rojas | Corporate Director | Jan 1, 2020 | |
| Nayda M Carrasquillo Medina | Corporate Officer | Jan 1, 2020 | |
| Miguel a Cabrera Caban | Contracted Managing Employee | Dec 2, 2013 | |
| Maria M Guzman | Corporate Officer | Jan 1, 2020 | |
| W-2 Managing Employee | Jan 1, 2020 |
Practitioners & affiliated clinicians
Affiliated clinicians 8
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": "1155859200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1223424000000",
"number": "1043324874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 ELEANOR ROOSEVELT ST.",
"address_2": "URB. EL VEDADO",
"city": "HATO REY",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-759-7035",
"fax_number": "787-759-7303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 ELEANOR ROOSEVELT ST.",
"address_2": "URB. EL VEDADO",
"city": "HATO REY",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-780-4010",
"fax_number": "787-787-5787"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SERVICIOS SUPLEMENTARIOS DE SALUD, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-18",
"last_updated": "2008-10-08",
"status": "A",
"authorized_official_last_name": "MARTINO",
"authorized_official_first_name": "CARMEN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "787-753-8095",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN MSN"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "PR",
"license": "12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hato Rey, PR
- Arelis Esther Segarra
- Sybelle M Serrano Santiago, MD
- Irma D Serrano, LND
- Servicios Conductuales del Caribe Inc.
- Servicios Integrados de Psicologia, Mediacion Y Arbitraje (Sipma), Inc
- Carmen J Sierra, MD
- Chanelle Edalmaly Silva, MD
- Simaging Diagnostic & Interventions-Sima
- Sleep Apnea Dental Solutions of Puerto Rico PSC
- Ruben Torres Solivan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.