NPIMap

Organization Active NPI

Costa Salud Community Health Centers, Inc

  • Clinical Medical Laboratory
  • Moca, PR
National Provider Identifier
1396517082
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
COSTA SALUD COMMUNITY HEALTH CENTERS, INC
Practice address
Calle Juan San Antonio 205
Edif Bosques, of 3
Moca, PR 00676
Phone
(787) 877-8300
Fax
(787) 877-8300
NPI assigned
Oct 25, 2023
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COSTA SALUD COMMUNITY HEALTH CENTERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Susana M Perez, LCDA
Title
Ceo
Phone
(787) 823-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

Calle Juan San Antonio 205
Edif Bosques, of 3
Moca, PR 00676

Mailing address

PO Box 638
Rincon, PR 00677-0638
Phone (787) 823-5500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120726000492 PR Part B Supplier - Independent Clinical Laboratory 1951370022 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Moca, PR; Rincon, PR

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Costa Salud Community Health Center13 organizations share this tax ID, including this one
Part of
Costa Salud Community Health Center

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1396517082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "RINCON",
            "state": "PR",
            "postal_code": "006770638",
            "telephone_number": "787-823-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE JUAN SAN ANTONIO 205",
            "address_2": "EDIF BOSQUES, OF 3",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "787-877-8300",
            "fax_number": "787-877-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTA SALUD COMMUNITY HEALTH CENTERS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTA SALUD COMMUNITY HEALTH CENTERS, INC",
        "enumeration_date": "2023-10-25",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "SUSANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-823-5500",
        "authorized_official_credential": "LCDA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moca, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.