NPIMap

Organization Active NPI

Hospicio Santa Rita, Inc.

  • Community Based Hospice Care Agency
  • Mayaguez, PR
National Provider Identifier
1104088608
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOSPICIO SANTA RITA, INC.
Practice address
Suite 210, Carr, 2 KM 1.59
Edif. Medical Emporium
Mayaguez, PR 00680-1143
Phone
(787) 652-1295
Fax
(787) 652-1297
NPI assigned
Jun 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Authorized official

Name
Mrs. Olga Lydia De Jesus
Title
Billing Officer
Phone
(787) 589-0003

Specialties & licenses 1

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

Addresses

Primary practice location

Suite 210, Carr, 2 KM 1.59
Edif. Medical Emporium
Mayaguez, PR 00680-1143

Mailing address

PO Box 1143
Aguada, PR 00602-1143
Phone (787) 589-0003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080905000650 PR Part A Provider - Hospice 8224104773 Practice locations: Cabo Rojo, PR

Hospice certification: CCN 401554

Legal name
HOSPICIO SANTA RITA, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 7, 1996
Last certification
Dec 16, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
May 7, 1996 in PR
Enrollment address
Carr. 100 KM 3.8, Bo Guanajibo
Cabo Rojo, PR 00623

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospicio Santa Rita IncCCN 401554
Ownership
For-Profit
Certified
May 7, 1996
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Gerardo Ruiz Individual 5% Or Greater Direct Ownership Interest May 7, 1996 50%
Corporate OfficerBoard Member/Adminstrator May 7, 1996 50%
Corporate DirectorBoard Member/Administrator May 7, 1996 50%
W-2 Managing EmployeeBoard Member/Administrator May 7, 1996 50%
Licedia Rosado Individual 5% Or Greater Direct Ownership Interest May 7, 1996 50%
Corporate DirectorBoard President May 7, 1996

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1104088608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1143",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006021143",
            "telephone_number": "787-589-0003",
            "fax_number": "787-252-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUITE 210, CARR, 2 KM 1.59",
            "address_2": "EDIF. MEDICAL EMPORIUM",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801143",
            "telephone_number": "787-652-1295",
            "fax_number": "787-652-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICIO SANTA RITA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "DE JESUS",
        "authorized_official_first_name": "OLGA",
        "authorized_official_middle_name": "LYDIA",
        "authorized_official_title_or_position": "BILLING OFFICER",
        "authorized_official_telephone_number": "787-589-0003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.