NPIMap

Organization Active NPI

Hospicio Sendero de Luz, Inc

  • Community Based Hospice Care Agency
  • Comerio, PR
National Provider Identifier
1447339130
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
25 Issued in PR
Legal business name
HOSPICIO SENDERO DE LUZ, INC
Practice address
9 Calle Georgetti
Comerio, PR 00782-2542
Phone
(787) 875-5701
Fax
(787) 875-0887
NPI assigned
Nov 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Juan C Santiago Sr., MHSA
Title
Executive Director
Phone
(787) 875-5701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 25 PR Primary

Addresses

Primary practice location

9 Calle Georgetti
Comerio, PR 00782-2542

Mailing address

PO Box 875
Comerio, PR 00782-0875
Phone (787) 875-5701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408000262 PR Part A Provider - Hospice 4183617616 Practice locations: Comerio, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447339130. Details of each certification follow.

Hospice certification: CCN 401552

Legal name
HOSPICIO SENDERO DE LUZ, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 5, 1996
Last certification
Jan 24, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Apr 13, 1994 in PR
Enrollment address
#9 Calle Georgetti
Comerio, PR 00782-2542

Care Compare: Hospice

Medicare Care Compare
Listed as
Sendero de Luz HospiceCCN 401552 · All quality measures
Ownership
For-Profit
Certified
Mar 5, 1996
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Miguel a Fuentes Oyola Individual 5% Or Greater Direct Ownership Interest Apr 13, 1994 20%
Corporate OfficerBoard Member Apr 13, 1994
Miguel a Rodriguez Rodriguez Individual Contracted Managing Employee Apr 13, 1994
Corporate Director Apr 13, 1994
Juan Santiago Berrios Individual 5% Or Greater Direct Ownership Interest Apr 13, 1994 20%
Corporate OfficerVice President/Director de Ejecu Apr 13, 1994 20%
Corporate DirectorVice President /Executive Direct Apr 13, 1994 20%
W-2 Managing EmployeeVice President / Executive Direc Apr 13, 1994 20%
Jose L Fuentes Oyola Individual 5% Or Greater Direct Ownership Interest Apr 13, 1994 20%
Corporate OfficerPresident Apr 13, 1994 20%
W-2 Managing EmployeePresident Apr 13, 1994 20%
Operational/Managerial ControlPresident Apr 13, 1994 20%
Minierva Vazquez Diaz Individual 5% Or Greater Direct Ownership Interest Apr 13, 1994 20%
Corporate OfficerTreasurer Service Coordinator Apr 13, 2013 20%
W-2 Managing EmployeeTreasurer/Service Coordinator Apr 13, 1994 20%
Lucia Hernandez Rivera Individual 5% Or Greater Direct Ownership Interest Apr 13, 1994 20%
Corporate OfficerCorporate Secretary Apr 13, 1994 20%
W-2 Managing EmployeeCorporate Secretary Apr 13, 1994 20%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447339130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 875",
            "city": "COMERIO",
            "state": "PR",
            "postal_code": "007820875",
            "telephone_number": "787-875-5701",
            "fax_number": "787-875-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CALLE GEORGETTI",
            "city": "COMERIO",
            "state": "PR",
            "postal_code": "007822542",
            "telephone_number": "787-875-5701",
            "fax_number": "787-875-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICIO SENDERO DE LUZ, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-875-5701",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PR",
            "license": "25",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Comerio, PR

Sources for this page

Verify at the official NPI Registry.