NPIMap

Organization Active NPI

Physician Healthcare Administration LLC

  • Emergency Medicine Physician
  • Arecibo, PR
National Provider Identifier
1457730871
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18074 Issued in PR
Legal business name
PHYSICIAN HEALTHCARE ADMINISTRATION LLC
Practice address
Carr 129 KM 0.1
Ave San Luis
Arecibo, PR 00612
Phone
(787) 817-3030
NPI assigned
May 19, 2015
Last updated
May 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Dr. Lizbette Lugo, CSP
Title
Owner
Phone
(787) 817-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X 18074 PR Primary

Addresses

Primary practice location

Carr 129 KM 0.1
Ave San Luis
Arecibo, PR 00612

Mailing address

PO Box 140549
Arecibo, PR 00614-0549
Phone (787) 817-3030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160331000779 PR Part B Supplier - Clinic/Group Practice 5698072940 Receives reassigned benefits from 19 practitioners
Practice locations: Mayaguez, PR

National Provider Directory

National Provider Directory

Locations

H14 Calle 1
Vega Baja, PR 00693
Phone (787) 855-5493

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1457730871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140549",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006140549",
            "telephone_number": "787-817-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 129 KM 0.1",
            "address_2": "AVE SAN LUIS",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-817-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN HEALTHCARE ADMINISTRATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "LUGO",
        "authorized_official_first_name": "LIZBETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-817-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CSP"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "18074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.