NPIMap

Organization Active NPI

Centro Integrado Medico de Aibonito

  • Health Maintenance Organization
  • Aibonito, PR
National Provider Identifier
1366465106
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
CENTRO INTEGRADO MEDICO DE AIBONITO
Practice address
Calle Julio Cintron 203 Altos
Aibonito, PR 00705
Phone
(787) 991-3222
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Diego D Vargas Gonzalez
Title
President
Phone
(787) 747-0022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

Calle Julio Cintron 203 Altos
Aibonito, PR 00705

Mailing address

PO Box 2010
Caguas, PR 00726-2010
Phone (787) 747-0022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050503000804 PR Part B Supplier - Clinic/Group Practice 4587604178 Receives reassigned benefits from 2 practitioners
Practice locations: Aibonito, PR

National Provider Directory

National Provider Directory

Locations

203 Calle Julio Cintron
Aibonito, PR 00705
Phone (787) 735-6391

Practitioners & affiliated clinicians

Practitioners 8

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": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1366465106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007262010",
            "telephone_number": "787-747-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE JULIO CINTRON 203 ALTOS",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-991-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO INTEGRADO MEDICO DE AIBONITO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "VARGAS GONZALEZ",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-747-0022"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.