NPIMap

Organization Active NPI

Quebradillas Medical Center PSC

  • Multi-Specialty Clinic/Center
  • Quebradillas, PR
National Provider Identifier
1417109240
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
QUEBRADILLAS MEDICAL CENTER PSC
Practice address
Carr #2 KM 96.8
Bo Cocos
Quebradillas, PR 00678
Phone
(787) 612-8094
NPI assigned
Oct 10, 2008
Last updated
Oct 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Juan Carlos Cruz Cruz, MDNPI 1518483734
Title
MD
Phone
(939) 429-2383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

Carr #2 KM 96.8
Bo Cocos
Quebradillas, PR 00678

Mailing address

42818 Carr 482
Quebradillas, PR 00678-1120
Phone (939) 429-2383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090223000045 PR Part B Supplier - Clinic/Group Practice 1052476272 Receives reassigned benefits from 5 practitioners
Practice locations: Quebradillas, PR

National Provider Directory

National Provider Directory
Tax ID family
Quebradillas Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1417109240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42818 CARR 482",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781120",
            "telephone_number": "939-429-2383",
            "fax_number": "787-500-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #2 KM 96.8",
            "address_2": "BO COCOS",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "telephone_number": "787-612-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEBRADILLAS MEDICAL CENTER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "CRUZ CRUZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "939-429-2383",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quebradillas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.