NPIMap

Organization Active NPI

Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas, Inc.

  • Home Health Agency
  • Arecibo, PR
National Provider Identifier
1063147387
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS, INC.
Practice address
Carr 2, KM 81.0
Office 203, Caribbean Cinemas BLDG
Arecibo, PR 00612-2040
Phone
(787) 878-5819
Fax
(787) 879-4321
NPI assigned
Jul 20, 2022
Last updated
Dec 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Authorized official

Name
Isuanet Castillo Medina, CPA
Title
Directora Ejecutiva Operacional
Phone
(787) 843-4185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

Carr 2, KM 81.0
Office 203, Caribbean Cinemas BLDG
Arecibo, PR 00612-2040

Mailing address

PO Box 7064
Ponce, PR 00732-7064
Phone (787) 878-5819

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220901002222 PR Part A Provider - Home Health Agency 3678957461 1 other NPI on this enrollment
Practice locations: Arecibo, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063147387. Details of each certification follow.

Home health agency certification: CCN 407309

Legal name
PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 1, 1973
Last certification
May 25, 2021
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2000 in PR
Enrollment address
Carr 2 KM 81.0 Bo.San Daniel
Office 203, Caribbean Cinemas BLDG
Arecibo, PR 00612-2040

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas IncCCN 407309 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Apr 1, 1973
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Servicios de Salud Episcopales, Inc. Organization, Ponce, PR Corporation, Consulting firm, Non-profit Operational/Managerial Control Sep 1, 2000
Evelyn Torres Rivera Individual Corporate DirectorBoard of Director-Secretary Sep 1, 2014
Rafael L Morales Maldonado Individual Corporate DirectorPresident Board of Director- Obi Jul 1, 2017
Juan a Salazar Trogolo Individual Corporate OfficerPrincipal Oficial Ejecutivo-Serv May 23, 2018
W-2 Managing EmployeePrincipal Oficial Ejecutivo-Serv May 23, 2018
Emilia Morales Vega Individual Corporate DirectorBoard of Director-Vice President Jan 1, 2006
Ana M Lago Correa Individual Corporate DirectorBoard of Director-Member Jan 1, 2012
Fernando Nieves Camacho Individual Corporate DirectorBoard of Director-Member May 1, 2015
Isuanet Castillo Medina Individual Corporate OfficerDirectora Ejecutiva Operacional Jul 3, 2008
W-2 Managing EmployeeDirectora Ejecutiva Operacional Jul 3, 2008
Iglesia Episcopal Puertorriquena, Inc Organization, San Juan, PR Corporation, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2000 100%
Angel Davila Individual Contracted Managing EmployeeMD; Mar 1, 2024
Corporate DirectorMedical Director Mar 1, 2024
Jose a Diaz Martinez Individual Corporate DirectorBoard of Director-Member May 1, 2018
Eileen I Torres Guadalupe Individual Corporate DirectorFinance Director Jul 8, 2024
W-2 Managing EmployeeFinance Director Jul 8, 2024
Rosemary de la Cruz Severino Individual Corporate OfficerPrincipal Oficial Financiera Dec 14, 2018
W-2 Managing EmployeePrincipal Oficial Financiera Dec 14, 2018
Lydia Colon Torres Individual Corporate DirectorBoard of Director- Member Aug 1, 2013

Owners & managing parties with NPI records 1

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Apr 1, 2022 Change of OwnershipThis provider was the buyer St Lukes Episcopal Church Home Care & Hospice ProgramCCN 407309, PR, NPI 1265426431

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1063147387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7064",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007327064",
            "telephone_number": "787-878-5819",
            "fax_number": "787-879-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 2, KM 81.0",
            "address_2": "OFFICE 203, CARIBBEAN CINEMAS BLDG",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006122040",
            "telephone_number": "787-878-5819",
            "fax_number": "787-879-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "CASTILLO MEDINA",
        "authorized_official_first_name": "ISUANET",
        "authorized_official_title_or_position": "DIRECTORA EJECUTIVA OPERACIONAL",
        "authorized_official_telephone_number": "787-843-4185",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.