NPIMap

Organization Active NPI

Yauco Healthcare Corporation

Doing business as Clinica de Medicina Conductual Pavia Ponce

  • Psychiatric/Mental Health Registered Nurse
  • Ponce, PR
National Provider Identifier
1386281053
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
Legal business name
YAUCO HEALTHCARE CORPORATION
Doing business as
Clinica de Medicina Conductual Pavia Ponce
Practice address
#92 Calle Sol Esquina Torres #75
Ponce, PR 00730
Phone
(787) 856-1000
Fax
(787) 267-6614
NPI assigned
Dec 2, 2019
Last updated
Jul 13, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
YAUCO HEALTH CARE CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Dinorah Hernandez
Title
Director Executive
Phone
(787) 856-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X Primary

Addresses

Primary practice location

#92 Calle Sol Esquina Torres #75
Ponce, PR 00730

Mailing address

PO Box 5643
Yauco, PR 00698-5643
Phone (787) 856-1000

Other names 1

  • Clinica de Medicina Conductual Pavia Ponce Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060511000358 PR Part A Provider - Hospital 5496746737 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ponce, PR; Yauco, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386281053. Details of each certification follow.

Hospital certification: CCN 400110

Legal name
YAUCO HEALTHCARE CORPORATION
Doing business as
HOSPITAL PAVIA YAUCO
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 27, 1980
Last certification
Mar 1, 2024
Beds
186
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
Oct 2, 2002 in PR
Enrollment address
Carretera 128 KM 1.0 Bo Susua
Hospital Pavia Yauco
Yauco, PR 6980001
Main/Primary Hospital Location
Hospital subgroups
General, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Hospital Pavia YaucoCCN 400110 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Yauco Healthcare Corp4 organizations share this tax ID, including this one
Part of
Yauco Healthcare Corp

Other organizations with this tax ID 3

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

Locations

92 Calle Sol
#75
Ponce, PR 00730

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Dinorah Hernandez Vazquez Individual Corporate Director May 21, 2015
W-2 Managing Employee May 21, 2015
Operational/Managerial Control May 21, 2015
Carmen Feliciano Vargas Individual 5% Or Greater Indirect Ownership Interest38.25 May 21, 2015
Operational/Managerial Control Oct 2, 2002 38.25%
Artau Holdings II LLC Organization, Guaynabo, PR Created for acquisition, LLC, Management services company, For-profit 5% Or Greater Direct Ownership Interest May 21, 2015 100%
Operational/Managerial Control May 21, 2015 100%
Marco Reyes Concepcion Individual Corporate DirectorRegional Director Jan 1, 2013
W-2 Managing EmployeeRegional Director Jan 1, 2013
Eduardo J Artau Gomez Individual 5% Or Greater Indirect Ownership Interest May 21, 2015 38.25%
Operational/Managerial Control Oct 2, 2002 38.25%
Karen Z Artau Feliciano Individual 5% Or Greater Indirect Ownership Interest May 21, 2015 7.83%
Operational/Managerial Control May 21, 2015 7.83%
Eduardo Artau Feliciano Individual 5% Or Greater Indirect Ownership Interest May 21, 2015 7.83%
Operational/Managerial Control May 21, 2015 7.83%
Francisco Artau Feliciano Individual 5% Or Greater Indirect Ownership Interest May 21, 2015 7.83%
Operational/Managerial Control May 21, 2015 7.83%
Elizabeth Gonzalez Individual Corporate DirectorFinance Director Dec 17, 2002
W-2 Managing EmployeeFinance Director Dec 17, 2002
Operational/Managerial Control Dec 17, 2002

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 18

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1386281053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5643",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006985643",
            "telephone_number": "787-856-1000",
            "fax_number": "787-267-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#92 CALLE SOL ESQUINA TORRES #75",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-856-1000",
            "fax_number": "787-267-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAUCO HEALTHCARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YAUCO HEALTH CARE CORP",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "DINORAH",
        "authorized_official_title_or_position": "DIRECTOR EXECUTIVE",
        "authorized_official_telephone_number": "787-856-1000"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica de Medicina Conductual Pavia Ponce",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinica de Medicina Conductual Pavia Ponce",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.