NPIMap

Organization Active NPI

Neomed Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Naguabo, PR
National Provider Identifier
1093357337
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEOMED CENTER, INC.
Practice address
Street #31 KM 3.7
Lot #2
Naguabo, PR 00718
Phone
(787) 737-2311
Fax
(787) 737-2377
NPI assigned
Oct 8, 2019
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NEOMED CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Rosa T Castro-Avila, MD
Title
Chief Executive Officer
Phone
(787) 737-2311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

Street #31 KM 3.7
Lot #2
Naguabo, PR 00718

Mailing address

PO Box 1278
Gurabo, PR 00778-1278
Phone (787) 737-2311

Other names 1

  • NeoMed Center-NA-OPD Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.neomedcenter.org Direct Neomed Center, Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211213002770 PR Part A Provider - Federally Qualified Health Center (FQHC) 1850284100 Practice locations: Naguabo, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093357337. Details of each certification follow.

Federally qualified health center certification: CCN 401868

Legal name
NEOMED CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 2021
Last certification
Dec 1, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 2, 1994 in PR
Enrollment address
Carretera #31 KM 3.7
Lote #2 El Duque Ward
Naguabo, PR 7180001

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Neomed Center Inc33 organizations share this tax ID, including this one
Part of
Neomed Center Inc

Other organizations with this tax ID 32

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

View all 32

Locations

21 Calle Munoz Rivera
Trujillo Alto, PR 00976
Phone (787) 748-0450

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.

NameRoleSinceShare
Miguel Gonzalez Gonzalez Individual Corporate Director Sep 1, 2010
Jonathan Melendez Avilez Individual W-2 Managing Employee Nov 16, 2021
Elvin Feliciano Echevarria Individual W-2 Managing Employee Nov 16, 2021
Rosa Castro Avila Individual Corporate Director Jan 1, 2010

Practitioners & affiliated clinicians

Practitioners 115

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.

View all 115

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1093357337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1278",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007781278",
            "telephone_number": "787-737-2311",
            "fax_number": "787-737-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STREET #31 KM 3.7",
            "address_2": "LOT #2",
            "city": "NAGUABO",
            "state": "PR",
            "postal_code": "00718",
            "telephone_number": "787-737-2311",
            "fax_number": "787-737-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOMED CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEOMED CENTER, INC.",
        "enumeration_date": "2019-10-08",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "CASTRO-AVILA",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "787-737-2311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.neomedcenter.org",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Neomed Center, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "941 San Antonio Final St Rt",
            "address_2": "SALIDA BARRIO JAGUAS",
            "city": "Gurabo",
            "state": "PR",
            "country_code": "US",
            "postal_code": "007781277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NeoMed Center-NA-OPD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NeoMed Center-NA-OPD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Naguabo, PR

Sources for this page

Verify at the official NPI Registry.