NPIMap

Organization Active NPI

HPM Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Carolina, PR
National Provider Identifier
1205200367
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HPM FOUNDATION INC
Practice address
Ab 20 Calle Morera
Valle Arriba Heights
Carolina, PR 00983-3402
Phone
(787) 468-2966
Fax
(787) 919-3956
NPI assigned
Nov 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Authorized official

Name
Ivonne Rivera
Title
Ceo
Phone
(787) 268-4171

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X PR
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

Ab 20 Calle Morera
Valle Arriba Heights
Carolina, PR 00983-3402

Mailing address

PO Box 14457
San Juan, PR 00916-4457
Phone (787) 268-4171

Other identifiers 1

IdentifierTypeStateIssuer
039430800MedicaidPR

Other names 1

  • HEALTHPROMED Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100406000251 PR Part B Supplier - Clinic/Group Practice 3870629579 Receives reassigned benefits from 65 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carolina, PR; Culebra, PR; Guaynabo, PR; San Juan, PR; Vieques, PR
O20190417001002 PR Part A Provider - Federally Qualified Health Center (FQHC) 3870629579 Practice locations: Carolina, PR

Federally qualified health center certification: CCN 401856

Legal name
HPM FOUNDATION INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 17, 2019
Last certification
Apr 17, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 24, 1987 in PR
Enrollment address
Urb. Valle Arriba Heights
Calle Morera Ab 20
Carolina, PR 9833622

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 7

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

National Provider Directory

National Provider Directory
Tax ID family
HPM Foundation Clinical Laboratory17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

AB20 Calle Morera
Carolina, PR 00983
Phone (787) 468-2966

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Ivonne Rivera Hernandez Individual Corporate DirectorExecutive Director Jun 1, 2016
W-2 Managing EmployeeCeo Jun 1, 2016
Nilsa Ortiz Individual Corporate DirectorContracting Coordinator Sep 16, 2019
Robert Cabello Individual Corporate DirectorCfo Jun 1, 2017
W-2 Managing EmployeeCfo Jun 1, 2017
Rose Marie Cisneros Calderon Individual Corporate DirectorBoard Member - Secretary Feb 12, 2019
Elba Marin Encarnacion Individual Corporate DirectorMember of Board of Directors May 31, 2010
Javier Matos Valenzuela Individual Corporate DirectorBoard Member May 31, 2010
Oscar Reinoso Cedo Individual Corporate DirectorMember of Board of Director Mar 1, 2014
Jessica Vazquez Vazquez Individual Corporate DirectorSupervisor Oct 6, 2020
Monica de Jesus Figueroa Individual Corporate DirectorBoard Member May 31, 2010
Nelson Cordero Gonzalez Individual Corporate DirectorMember of Board of Director May 1, 2014
Veronica Melendez Gonzalez Individual Corporate DirectorMember of Board of Director Nov 1, 2014
Zaida I Torres Rodriguez Individual Corporate DirectorMember of Board of Directors Mar 27, 2018
Carmen Torres Escute Individual Corporate DirectorSecretaria de la Junta Directore Dec 1, 2016

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1205200367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14457",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009164457",
            "telephone_number": "787-268-4171",
            "fax_number": "787-919-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AB 20 CALLE MORERA",
            "address_2": "VALLE ARRIBA HEIGHTS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009833402",
            "telephone_number": "787-468-2966",
            "fax_number": "787-919-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HPM FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "IVONNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-268-4171"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "PR",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039430800",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHPROMED",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.