NPIMap

Organization Active NPI

Neomed Center, Inc.

Doing business as NeoMed Center - Aguas Buenas

  • Federally Qualified Health Center (FQHC)
  • Aguas Buenas, PR
National Provider Identifier
1427435189
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEOMED CENTER, INC.
Doing business as
NeoMed Center - Aguas Buenas
Practice address
Carr 156 KM 41.3
Aguas Buenas, PR 00703
Phone
(787) 737-2311
Fax
(787) 737-0244
NPI assigned
May 1, 2015
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NEOMED CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Rosa T Castro-Avila, M.D.
Title
Ceo
Phone
(787) 737-2311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Clinical Medical Laboratory 291U00000X NU

Addresses

Primary practice location

Carr 156 KM 41.3
Aguas Buenas, PR 00703

Mailing address

PO Box 1277
Gurabo, PR 00778-1277
Phone (787) 737-2311

Other names 1

  • NeoMed Center - Aguas Buenas Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150629000360 PR Part A Provider - Federally Qualified Health Center (FQHC) 1850284100 Practice locations: Aguas Buenas, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427435189. Details of each certification follow.

Federally qualified health center certification: CCN 401829

Legal name
NEOMED CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 29, 2015
Last certification
Jun 29, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
Carr 156 KM 41.3
Bo Bayamoncito
Aguas Buenas, PR 7030001

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Neomed Center - Mobile Unit33 organizations share this tax ID, including this one
Part of
Neomed Center - Mobile Unit

Other organizations with this tax ID 32

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

View all 32

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Jonathan Melendez Avilez Individual W-2 Managing EmployeeCco Jun 10, 2015
Rosa Castro Avila Individual Corporate OfficerCeo Jun 10, 2015
W-2 Managing EmployeeAd;Ceo Jun 10, 2015

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1427435189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1277",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007781277",
            "telephone_number": "787-737-2311",
            "fax_number": "787-737-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 156 KM 41.3",
            "city": "AGUAS BUENAS",
            "state": "PR",
            "postal_code": "00703",
            "telephone_number": "787-737-2311",
            "fax_number": "787-737-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOMED CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEOMED CENTER, INC.",
        "enumeration_date": "2015-05-01",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "CASTRO-AVILA",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-737-2311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NeoMed Center - Aguas Buenas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aguas Buenas, PR

Sources for this page

Verify at the official NPI Registry.