NPIMap

Organization Active NPI

Centro de Servicios Primarios de Salud,Inc.

  • Community Health Clinic/Center
  • Florida, PR
National Provider Identifier
1235394305
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
114 Issued in PR
Legal business name
CENTRO DE SERVICIOS PRIMARIOS DE SALUD,INC.
Practice address
3 Calle Antonio Alcazar
Florida, PR 00650-1912
Phone
(787) 822-2170
NPI assigned
Jul 28, 2008
Last updated
Nov 20, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRO DE SERVICIOS PRIMARIOS DE SALUD,INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Mrs. Rosa Agostini
Title
Executive Director
Phone
(787) 822-2170

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 114 PR Primary
Clinical Medical Laboratory 291U00000X 735 PR

Addresses

Primary practice location

3 Calle Antonio Alcazar
Florida, PR 00650-1912

Mailing address

3 Calle Antonio Alcazar
Florida, PR 00650-1912
Phone (787) 822-2170

Other identifiers 2

IdentifierTypeStateIssuer
4020107OtherPRNABP
40D0680461OtherPRCLIA LAB.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121113000168 PR Part B Supplier - Independent Clinical Laboratory 1456549005 Practice locations: Florida, PR

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Lab Clin Ctro SVC Primari6 organizations share this tax ID, including this one
Part of
Lab Clin Ctro SVC Primari

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1235394305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CALLE ANTONIO ALCAZAR",
            "city": "FLORIDA",
            "state": "PR",
            "postal_code": "006501912",
            "telephone_number": "787-822-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CALLE ANTONIO ALCAZAR",
            "city": "FLORIDA",
            "state": "PR",
            "postal_code": "006501912",
            "telephone_number": "787-822-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE SERVICIOS PRIMARIOS DE SALUD,INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRO DE SERVICIOS PRIMARIOS DE SALUD,INC.",
        "enumeration_date": "2008-07-28",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "AGOSTINI",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-822-2170",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "PR",
            "license": "114",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "735",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4020107",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LAB.",
            "identifier": "40D0680461",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florida, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.