Metro Pavia at Home, LLC
Organization Active NPI Home Health Agency · Arecibo, PR
NPI 1437563418 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1437563418
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- METRO PAVIA AT HOME, LLC
- Practice address
- Metropolitan Office Building
153 Ave Jose de Diego Suite 205
Arecibo, PR 00612 - Phone
- (787) 817-0498
- Fax
- (787) 705-6794
- NPI assigned
- Jun 17, 2014
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lisandra Velez Gonzalez
- Title
- Executive Director
- Phone
- (787) 705-6982
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 10
Medicare Care Compare: Home health agency
- Listed as
- Metro Pavia @ Home
- Overall star rating
- ★★★★★ 4.5 of 5
- Ownership
- Proprietary
- Certified
- Jul 5, 1988
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Home health agency certification: CCN 407024
- Legal name
- METRO PAVIA AT HOME, LLC
- Doing business as
- METRO PAVIA @ HOME
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 5, 1988
- Last certification
- Sep 30, 2020
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Mar 28, 2014 in PR
- Enrollment address
- 153 Ave Jose de Diego
Ste 205
Arecibo, PR 00612-4779
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Johny Arzola Mangual |
Corporate Director | Jun 1, 2014 | 10% |
| W-2 Managing Employee | Jun 1, 2014 | 10% | |
| Carlos J Fuentes-Lopez |
Corporate Director |
Sep 1, 2019 | 10% |
| Lorenzo I Serra-Castro |
W-2 Managing Employee |
Jan 14, 2019 | 25% |
| Eduardo J Artau Gomez |
5% Or Greater Direct Ownership Interest |
Jun 1, 2014 | 100% |
| Corporate Officer |
Jun 1, 2014 | 100% | |
| Siomara Pimentel-Rivera |
W-2 Managing Employee |
Apr 27, 2017 | 25% |
| Nilmar C Maldonado-Martinez |
W-2 Managing Employee |
Sep 30, 2019 | 15% |
| Iris N Garcia Arroyo |
Corporate Officer |
Jun 1, 2014 | 25% |
| W-2 Managing Employee |
Jun 1, 2014 | 25% | |
| Operational/Managerial Control |
Jun 1, 2014 | 25% | |
| Laura I Sola |
W-2 Managing Employee |
Jun 30, 2020 | 25% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140820000048 | PR | Part a Provider - Home Health Agency | 1557589363 | Practice locations: Adjuntas, PR; Arecibo, PR |
National Provider Directory
- Tax ID family
- Metro Pavia at Home LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
Metropolitan Office Building
153 Ave Jose de Diego Suite 205
Arecibo, PR 00612
Mailing address
P.O.
Box 11938
San Juan, PR 00922-1938
Phone (787) 705-6982
Other practice location 1
Parque Industrial El Tuque Calle A 107
Ponce, PR 00728
Phone (787) 829-7710
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037568700 | Medicaid | PR |
Other names
- Metro Pavia at Home
Other providers in Arecibo, PR
- Luis Rafael Mercado
- Yajahyra Mercado
- Yiashera Z Mercado
- Metorpolitae Anesthesia and Analgesia
- Metro Pavia at Home LLC
- Metro Pavia Healthcare Center
- Metro Pavia Healthcare Center
- Metro Pavia Healthcare Center
- Metro Pavia Healthcare Centers
- Metro Pavia Healthcare Centers Inc
All providers in Arecibo, PR · Home Health Agency in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.