NPIMap

Organization Active NPI

MMC Family Medical Center LLC

  • Primary Care Clinic/Center
  • Vega Baja, PR
National Provider Identifier
1285008797
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MMC FAMILY MEDICAL CENTER LLC
Practice address
Carr 687 KM 0.1
Bo. Algarrobo
Vega Baja, PR 00693-0000
Phone
(787) 621-3724
Fax
(787) 621-3715
NPI assigned
Nov 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Mrs. Noriselle Rivera
Title
VP Finance
Phone
(787) 621-3724

Specialties & licenses 1

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

Addresses

Primary practice location

Carr 687 KM 0.1
Bo. Algarrobo
Vega Baja, PR 00693-0000

Mailing address

100 Carr 165 Tower 1
Suite 508
Guaynabo, PR 00968-8052
Phone (787) 621-3724

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160212001775 PR Part B Supplier - Clinic/Group Practice 0547564403 Receives reassigned benefits from 8 practitioners
Practice locations: Manati, PR

National Provider Directory

National Provider Directory

Locations

100 Carr 165
Ste 508
Guaynabo, PR 00968

B23 Calle 3
Manati, PR 00674
Phone (787) 621-3724

120 Carr 687
Vega Baja, PR 00693
Phone (787) 533-7520

Practitioners & affiliated clinicians

Practitioners 9

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": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1285008797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CARR 165 TOWER 1",
            "address_2": "SUITE 508",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009688052",
            "telephone_number": "787-621-3724",
            "fax_number": "787-621-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 687 KM 0.1",
            "address_2": "BO. ALGARROBO",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006930000",
            "telephone_number": "787-621-3724",
            "fax_number": "787-621-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC FAMILY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "NORISELLE",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "787-621-3724",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.