NPIMap

Organization Active NPI

Puerto Rican Organization to Motivate Enlighten and Serve Addicts, Inc

Doing business as Promesa Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bronx, NY
National Provider Identifier
1407034614
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
170811936 Issued in NY
Legal business name
PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS, INC
Doing business as
Promesa Inc
Practice address
1776 Clay Ave
Bronx, NY 10457
Phone
(718) 299-1100
NPI assigned
Feb 11, 2008
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Vicky Gatell
Title
Chief Financial Officer
Phone
(718) 960-7629

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 170811936 NY Primary

Addresses

Primary practice location

1776 Clay Ave
Bronx, NY 10457

Mailing address

311 E 175TH St
Bronx, NY 10457-5859
Phone (718) 960-7568

Other practice location 1

561 Court St
Brooklyn, NY 11231-3804
Phone (718) 780-7421

Other identifiers 1

IdentifierTypeStateIssuer
03012360MedicaidNY

Other names 1

  • Promesa Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040315000368 NY Part B Supplier - Clinic/Group Practice 5395634539 Receives reassigned benefits from 6 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY
O20200218000961 NY Part B Supplier - Opioid Treatment Program (Otp) 5395634539 5 other NPIs on this enrollment
Practice locations: Albany, NY; Bronx, NY; Brooklyn, NY; Buffalo, NY; Dunkirk, NY

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

561 Court St
Brooklyn, NY 11231
Phone (718) 780-7421

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1407034614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E 175TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104575859",
            "telephone_number": "718-960-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 CLAY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-299-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "561 Court St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112313804",
            "country_code": "US",
            "telephone_number": "718-780-7421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "GATELL",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-960-7629"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "170811936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03012360",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promesa Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Promesa Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.