NPIMap

Organization Active NPI

Ryder Memorial Hospital, Inc.

Doing business as Ryder Memorial Hopice Program

  • Community Based Hospice Care Agency
  • Humacao, PR
National Provider Identifier
1093906844
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
#18 Issued in PR
Legal business name
RYDER MEMORIAL HOSPITAL, INC.
Doing business as
Ryder Memorial Hopice Program
Practice address
355 Ave Font Martelo
Humacao, PR 00791-3249
Phone
(787) 852-0768
Fax
(787) 852-0899
NPI assigned
Aug 7, 2007
Last updated
Sep 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Mr. Jose Ramon Feliciano, MHSA
Title
Executive Director
Phone
(787) 852-0768

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X #18 PR Primary

Addresses

Primary practice location

355 Ave Font Martelo
Humacao, PR 00791-3249

Mailing address

355 Ave Font Martelo
PO Box 859
Humacao, PR 00791-3249
Phone (787) 852-0768

Other names 1

  • Ryder Memorial Hopice Program Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130715000808 PR Part A Provider - Hospice 2264499011 Practice locations: Humacao, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093906844. Details of each certification follow.

Hospice certification: CCN 401543

Legal name
RYDER MEMORIAL HOSPITAL INC
Doing business as
RYDER MEMORIAL HOSPICE PROGRAM
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 28, 1993
Last certification
Oct 15, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 1967 in PR
Enrollment address
355 Ave Font Martelo
Humacao, PR 00791-3249

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Ryder Memorial Hospice ProgramCCN 401543 · All quality measures
Ownership
Non-Profit
Certified
Dec 28, 1993
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Gloria J Mendez Individual W-2 Managing EmployeeHome Care Director Jul 6, 2021
Ryder Memorial Hospital Inc Organization, Humacao, PR Non-profit 5% Or Greater Direct Ownership Interest Jul 28, 2023 100%
Carmen Colon Individual Corporate DirectorExecutive Director Feb 1, 2021

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ryder Skill Nursing FacilityHumacao, PR, CCN 405018 Skilled nursing facility Operational/Managerial Control
Trustee of the SNF
Adp of the SNF		 Jan 13, 1988
Jan 13, 1988
Jan 13, 1988
Ryder Homecare ProgramHumacao, PR, CCN 407005 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 15, 1974
Apr 15, 1974

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1093906844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 AVE FONT MARTELO",
            "address_2": "PO BOX 859",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913249",
            "telephone_number": "787-852-0768",
            "fax_number": "787-852-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 AVE FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913249",
            "telephone_number": "787-852-0768",
            "fax_number": "787-852-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYDER MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "FELICIANO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "RAMON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-852-0768",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PR",
            "license": "#18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ryder Memorial Hopice Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.