NPIMap

Organization Active NPI

Med Centro, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ponce, PR
National Provider Identifier
1295727147
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MED CENTRO, INC.
Practice address
1034 Ave Hostos
Ponce, PR 00716-1115
Phone
(787) 843-9393
Fax
(787) 841-0077
NPI assigned
Aug 17, 2005
Last updated
Sep 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
Mr. Allan Cintron-Salichs, MBA, MHCM
Title
Executive Director
Phone
(787) 843-9393

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Clinic/Center 261Q00000X
Dental Clinic/Center 261QD0000X
Emergency Care Clinic/Center 261QE0002X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Mammography Clinic/Center 261QR0206X
Urgent Care Clinic/Center 261QU0200X
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

1034 Ave Hostos
Ponce, PR 00716-1115

Mailing address

PO Box 220
Mercedita, PR 00715-0220
Phone (787) 843-9393

Other practice location 1

1046 Ave Hostos
Ponce, PR 00716-1118
Phone (787) 843-9393

Other practice location 2

72 Calle Mayor
Ponce, PR 00730-3724
Phone (787) 843-9393

Other practice location 3

Calle H N-9 Nueva Vida El Tuque
Ponce, PR 00728-6725
Phone (787) 843-9393

Other practice location 4

Carr. 385 Km 6.5 Bo. Cuebas
Penuelas, PR 00624-7501
Phone (787) 843-9393

Other practice location 5

Carr. 149 Km 57.7 Villalba Arriba
Villalba, PR 00766-3402
Phone (787) 843-9393

Other practice location 6

Carr.1 Km 135.5 Bo. Capitanejo Sector Singapur
Juana Diaz, PR 00795-0000
Phone (787) 843-9393

Other practice location 7

138 Luis Munoz Marin Ave.
Coamo, PR 00769-0000
Phone (787) 843-9393

Other names 1

  • Consejo de Salud de Puerto Rico, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20031216000213 PR Part B Supplier - Clinic/Group Practice 5890692131 Receives reassigned benefits from 92 practitioners
16 other NPIs on this enrollment
Practice locations: Ponce, PR; Villalba, PR; Penuelas, PR; Juana Diaz, PR; Coamo, PR
O20050625000025 PR Part B Supplier - Independent Clinical Laboratory 5890692131 2 other NPIs on this enrollment
Practice locations: Penuelas, PR; Ponce, PR
O20051102000919 PR Part B Supplier - Clinic/Group Practice 5890692131 Receives reassigned benefits from 24 practitioners
3 other NPIs on this enrollment
Practice locations: Penuelas, PR; Ponce, PR
O20111004000177 PR Part B Supplier - Ambulatory Surgical Center 5890692131 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Ponce, PR
O20141110000133 PR Part A Provider - Federally Qualified Health Center (FQHC) 5890692131 Practice locations: Ponce, PR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1295727147. Details of each certification follow.

Federally qualified health center certification: CCN 401822

Legal name
MED CENTRO INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 10, 2014
Last certification
Nov 10, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 4, 1971 in PR
Enrollment address
1034 Ave Hostos
Ponce, PR 7161115

Federally qualified health center certification: CCN 401864

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MED CENTRO, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 5, 2020
Last certification
Oct 5, 2020
Ownership / control type
For profit – corporation
Facility address
138 Luis M Marin Avenue
Coamo, PR 00769

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 19

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

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Med Centro Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Carmen Cruz-Cancel Individual Corporate DirectorVocal-Board of Directors Feb 28, 2018
Allan Cintron-Salichs Individual Corporate DirectorExecutive Director Mar 16, 2006 100%
W-2 Managing EmployeeExecutive Director Mar 16, 2006 100%
Samuel Santos Rivera Individual Corporate DirectorVocal-Board of Directors Aug 23, 2023
Maria Roque-Torruella Individual Corporate DirectorSecretary Board of Directors Sep 6, 2011
Sol Belfort-Maldonado Individual Corporate DirectorVocal-Board of Directors Sep 26, 2012
Jorge Morales Torres Individual Corporate DirectorVocal-Board of Directors Jan 27, 2021
Jose O Coll-Diaz Individual Corporate DirectorEx Officious Jan 1, 2011
Pedro Velez Acosta Individual Corporate DirectorVocal-Board of Directors Feb 26, 2014
Jaime Garcia-Ramirez Individual Corporate DirectorVocal-Board of Directors Jan 1, 2008
Marilyn Santiago Ayala Individual Corporate DirectorVocal-Board of Directors Mar 31, 2021
Gladys Santos-Cintron Individual Corporate DirectorVice President Board of Director Jan 1, 1988
Victor Montalvo-Martell Individual Corporate DirectorTreasurer Board of Directors Jan 1, 2008
Ileana Yambo Febus Individual Corporate DirectorVocal-Board of Directors Mar 31, 2021
Eduardo Martinez-Tull Individual Corporate DirectorPresident Board of Directors Jan 1, 2005
Ramberto Rivera Oliveras Individual Corporate DirectorVocal-Board of Directors Apr 24, 2024
Ivan Madera Rodríguez Individual Corporate DirectorVocal-Board of Directors Feb 22, 2023

Practitioners & affiliated clinicians

Practitioners 100

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 100

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1295727147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "MERCEDITA",
            "state": "PR",
            "postal_code": "007150220",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 AVE HOSTOS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007161115",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 Ave Hostos",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007161118",
            "country_code": "US",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72 Calle Mayor",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007303724",
            "country_code": "US",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Calle H N-9 Nueva Vida El Tuque",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007286725",
            "country_code": "US",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Carr. 385 Km 6.5 Bo. Cuebas",
            "address_purpose": "LOCATION",
            "city": "Penuelas",
            "state": "PR",
            "postal_code": "006247501",
            "country_code": "US",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Carr. 149 Km 57.7 Villalba Arriba",
            "address_purpose": "LOCATION",
            "city": "Villalba",
            "state": "PR",
            "postal_code": "007663402",
            "country_code": "US",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Carr.1 Km 135.5 Bo. Capitanejo Sector Singapur",
            "address_purpose": "LOCATION",
            "city": "Juana Diaz",
            "state": "PR",
            "postal_code": "007950000",
            "country_code": "US",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "138 Luis Munoz Marin Ave.",
            "address_purpose": "LOCATION",
            "city": "Coamo",
            "state": "PR",
            "postal_code": "007690000",
            "country_code": "US",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MED CENTRO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2024-09-05",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "CINTRON-SALICHS",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-843-9393",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, MHCM"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Consejo de Salud de Puerto Rico, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.