NPIMap

Organization Active NPI

Migrant Health Center Western Region, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mayaguez, PR
National Provider Identifier
1336407360
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
575911 Issued in PR
Legal business name
MIGRANT HEALTH CENTER WESTERN REGION, INC.
Practice address
Numero 189 Interior
Avenida Duscome
Mayaguez, PR 00680-0000
Phone
(787) 805-4870
Fax
(787) 834-1924
NPI assigned
Apr 27, 2012
Last updated
Apr 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Mr. Reynaldo Serrano Caraballo, MR.
Title
Director Ejecutivo
Phone
(787) 805-7360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 575911 PR Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

Numero 189 Interior
Avenida Duscome
Mayaguez, PR 00680-0000

Mailing address

PO Box 190
Mayaguez, PR 00681-0190
Phone (787) 805-7360

Other names 1

  • MIGRANT HEALTH CENTER WESTERN REGION, INC. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121218000554 PR Part A Provider - Federally Qualified Health Center (FQHC) 4183520810 Practice locations: Mayaguez, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336407360. Details of each certification follow.

Federally qualified health center certification: CCN 401817

Legal name
MIGRANT HEALTH CENTER WESTERN REGION,INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 24, 2012
Last certification
Jul 24, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 24, 1986 in PR
Enrollment address
Ave Duscombe
#189 Interior
Mayaguez, PR 6800000
Related CCNs
401804

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Migrant Health Center Western Regioninc70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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
Enid Ortiz Martell Individual Contracted Managing EmployeeSupervisor Contratos Jan 1, 2022
W-2 Managing EmployeeSupervisor de Contratos Jan 1, 2022
Nestor Bracero Ledesma Individual Contracted Managing EmployeeCeo Assistant Jan 1, 2022
Operational/Managerial ControlCeo Assistant Jan 1, 2022
Tania Rodriguez Individual Corporate DirectorCeo Jan 1, 2022 80%

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1336407360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810190",
            "telephone_number": "787-805-7360",
            "fax_number": "787-834-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NUMERO 189 INTERIOR",
            "address_2": "AVENIDA DUSCOME",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006800000",
            "telephone_number": "787-805-4870",
            "fax_number": "787-834-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGRANT HEALTH CENTER WESTERN REGION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-27",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "CARABALLO",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_middle_name": "SERRANO",
        "authorized_official_title_or_position": "DIRECTOR EJECUTIVO",
        "authorized_official_telephone_number": "787-805-7360",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MR."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "PR",
            "license": "575911",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIGRANT HEALTH CENTER WESTERN REGION, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.