NPIMap

Organization Active NPI

Hospital Menonita Ponce Inc

Doing business as Grupo Medico Menonita Ponce

  • Specialist
  • Ponce, PR
National Provider Identifier
1336859479
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HOSPITAL MENONITA PONCE INC
Doing business as
Grupo Medico Menonita Ponce
Practice address
Carr PR 506 KM 1.0, Bo Coto Laurel
Ponce, PR 00780-0000
Phone
(787) 434-1700
Fax
(787) 434-1711
NPI assigned
Nov 30, 2022
Last updated
Dec 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Lissette Vazquez Rivera
Title
Director
Phone
(787) 434-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

Carr PR 506 KM 1.0, Bo Coto Laurel
Ponce, PR 00780-0000

Mailing address

PO Box 1650
Cidra, PR 00739-1650
Phone (787) 434-1700

Other names 1

  • Grupo Medico Menonita Ponce Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lvazquez@mghpr.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230728000428 PR Part B Supplier - Clinic/Group Practice 1759753668 Receives reassigned benefits from 28 practitioners
Practice locations: Ponce, 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
Hospital Menonita Ponce Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

6 Calle La Cruz
Juana Diaz, PR 00795
Phone (787) 837-2265

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1336859479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1650",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007391650",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR PR 506 KM 1.0, BO COTO LAUREL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007800000",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL MENONITA PONCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ RIVERA",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-434-1700"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvazquez@mghpr.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lvazquez@mghpr.org",
            "address_1": "Carr PR 506 Km 1.0, Bo Coto Laurel",
            "city": "Ponce",
            "state": "PR",
            "country_code": "US",
            "postal_code": "007800000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grupo Medico Menonita Ponce",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grupo Medico Menonita Ponce",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.