Hospicio Sendero de Luz, Inc

Key facts

NPI: 1447339130
Entity type: Organization (NPI type 2)
Primary specialty: Community Based Hospice Care Agency 251G00000X
License: 25 (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
Organization subpart: No

Authorized official

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

Owners & managing parties with NPI records 1

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

Miguel Angel Rodriguez, MD General Practice Physician · Comerio, PR · NPI 1386685626

CMS ownership CONTRACTED MANAGING EMPLOYEE · CORPORATE DIRECTOR

Affiliated clinicians 1

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

Wilmer Rodriguez Diaz, M.D. General Practice Physician · Corozal, PR · NPI 1154567493

Care Compare affiliation Hospice

Medicare Care Compare: Hospice

Listed as: Sendero de Luz Hospice CCN 401552
Ownership: For-Profit
Certified: Mar 5, 1996
Medicare certification status: Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PR

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: Corporation · Proprietary
Incorporated: Apr 13, 1994 in PR
Enrollment address: #9 Calle Georgetti
Comerio, PR 00782-2542

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.

Name	Role	Since	Share
Miguel a Fuentes Oyola Individual	5% Or Greater Direct Ownership Interest	Apr 13, 1994	20%
Miguel a Fuentes Oyola Individual	Corporate Officer Board Member	Apr 13, 1994
Miguel a Rodriguez Rodriguez Individual	Contracted Managing Employee	Apr 13, 1994
Miguel a Rodriguez Rodriguez Individual	Corporate Director	Apr 13, 1994
Juan Santiago Berrios Individual	5% Or Greater Direct Ownership Interest	Apr 13, 1994	20%
	Corporate Officer Vice President/Director de Ejecu	Apr 13, 1994	20%
	Corporate Director Vice President /Executive Direct	Apr 13, 1994	20%
	W-2 Managing Employee Vice President / Executive Direc	Apr 13, 1994	20%
Jose L Fuentes Oyola Individual	5% Or Greater Direct Ownership Interest	Apr 13, 1994	20%
	Corporate Officer President	Apr 13, 1994	20%
	W-2 Managing Employee President	Apr 13, 1994	20%
	Operational/Managerial Control President	Apr 13, 1994	20%
Minierva Vazquez Diaz Individual	5% Or Greater Direct Ownership Interest	Apr 13, 1994	20%
	Corporate Officer Treasurer Service Coordinator	Apr 13, 2013	20%
	W-2 Managing Employee Treasurer/Service Coordinator	Apr 13, 1994	20%
Lucia Hernandez Rivera Individual	5% Or Greater Direct Ownership Interest	Apr 13, 1994	20%
	Corporate Officer Corporate Secretary	Apr 13, 1994	20%
	W-2 Managing Employee Corporate Secretary	Apr 13, 1994	20%

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20040408000262	PR	Part a Provider - Hospice	4183617616	Practice locations: Comerio, PR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community Based Hospice Care Agency	251G00000X	25	PR	Yes

Addresses

Primary practice location

9 Calle Georgetti
Comerio, PR 00782-2542

Mailing address

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

Other identifiers

Identifier	Type	State	Issuer
10915	Other	PR	HOSPICE
7820009	Other	PR	HOSPICE

Other providers in Comerio, PR

All providers in Comerio, PR · Community Based Hospice Care 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 Aug 22, 2020. 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.

Verify at the official NPI Registry.