NPIMap

Organization Active NPI

Hospicio la Monserrate

  • Community Based Hospice Care Agency
  • Sabana Grande, PR
National Provider Identifier
1225435324
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
13-016 Issued in PR
Legal business name
HOSPICIO LA MONSERRATE
Practice address
14 Ave Quilinchini
1
Sabana Grande, PR 00637-0000
Phone
(787) 873-5998
Fax
(787) 873-6001
NPI assigned
Dec 4, 2014
Last updated
Oct 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Authorized official

Name
Mrs. Mayra R Mendez, M.A. BUSSINESS ADM
Title
Secretary
Phone
(787) 873-5999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 13-016 PR Primary

Addresses

Primary practice location

14 Ave Quilinchini
1
Sabana Grande, PR 00637-0000

Mailing address

PO Box 1263
Aguada, PR 00602-1263
Phone (787) 873-5998

Other identifiers 3

IdentifierTypeStateIssuer
401573OtherPRCMS CERTIFICATIONS
568042OtherPRJOINT COMMISSION CERTIFICATION
48OtherPRLICENCIA DEL ESTADO

Other names 1

  • HOSPICIO LA MONSERRATE Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150514002691 PR Part A Provider - Hospice 7618297656 Practice locations: Sabana Grande, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225435324. Details of each certification follow.

Hospice certification: CCN 401573

Legal name
HOSPICIO LA MONSERRATE
Doing business as
HOSPICIO LA MONSERRATE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 27, 2016
Last certification
Jan 20, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 30, 2013 in PR
Enrollment address
14 Ave Quilinchini 1
Sabana Grande, PR 00637

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospicio la MonserrateCCN 401573 · All quality measures
Ownership
For-Profit
Certified
May 27, 2016
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

14 Ave Vicente Quilinchini
#1
Sabana Grande, PR 00637
Phone (787) 873-5998

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
Home Health la Monserrate, Inc Organization, Sabana Grande, PR Created for acquisition, For-profit 5% Or Greater Direct Ownership Interest Oct 30, 2013 100%
Operational/Managerial Control Oct 30, 2013 100%
Wilkins Feliciano Acevedo Individual 5% Or Greater Direct Ownership InterestOwner Oct 30, 2013 50%
Corporate DirectorPresident Oct 30, 2013 50%
W-2 Managing EmployeePresident Oct 30, 2013 50%
Mayra R Mendez Carrero Individual 5% Or Greater Direct Ownership InterestOwner Oct 30, 2013 50%
Corporate DirectorVP Oct 30, 2013 50%
W-2 Managing EmployeeVP Oct 30, 2013 50%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1225435324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1263",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006021263",
            "telephone_number": "787-873-5998",
            "fax_number": "787-873-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 AVE QUILINCHINI",
            "address_2": "1",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006370000",
            "telephone_number": "787-873-5998",
            "fax_number": "787-873-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICIO LA MONSERRATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "787-873-5999",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A. BUSSINESS ADM"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PR",
            "license": "13-016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CERTIFICATIONS",
            "identifier": "401573",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOINT COMMISSION CERTIFICATION",
            "identifier": "568042",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA DEL ESTADO",
            "identifier": "48",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOSPICIO LA MONSERRATE",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sabana Grande, PR

Sources for this page

Verify at the official NPI Registry.