Organization Active NPI

Prime Medica PSC

  • Primary Care Clinic/Center
  • Aguada, PR
National Provider Identifier
1215340567
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PRIME MEDICA PSC
Practice address
HC 3 Box 39603
Aguada, PR 00602-9794
Phone
(787) 868-0345
Fax
(787) 868-0345
NPI assigned
Jun 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Authorized official

Name
Hiram J Ortega, M.D.NPI 1336125368
Title
President
Phone
(787) 868-0345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

HC 3 Box 39603
Aguada, PR 00602-9794

Mailing address

HC 3 Box 39603
Aguada, PR 00602-9794
Phone (787) 868-0345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180320002490 PR Part B Supplier - Clinic/Group Practice 3870855422 Receives reassigned benefits from 2 practitioners
Practice locations: Aguada, PR

National Provider Directory

National Provider Directory

Locations

39603 HC 3
Aguada, PR 00602
Phone (787) 868-0345

Practitioners & affiliated clinicians

Practitioners 3

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": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1215340567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 39603",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006029794",
            "telephone_number": "787-868-0345",
            "fax_number": "787-868-0345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 39603",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006029794",
            "telephone_number": "787-868-0345",
            "fax_number": "787-868-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICA PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "HIRAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-868-0345",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguada, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.