NPIMap

Organization Active NPI

Lares Medical Center Inc

  • Emergency Care Clinic/Center
  • Lares, PR
National Provider Identifier
1477580496
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
119 Issued in PR
Legal business name
LARES MEDICAL CENTER INC
Practice address
Carr 111 KM 2.9 Ave Los Patriotas
Lares, PR 00669-1427
Phone
(787) 897-1444
Fax
(787) 897-4952
NPI assigned
Jun 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Authorized official

Name
Dr. Rodriguez Cruz Baltazar, M.D.
Title
Medico
Phone
(787) 897-1444

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 119 PR Primary
Health Service Clinic/Center 261QH0100X PR

Addresses

Primary practice location

Carr 111 KM 2.9 Ave Los Patriotas
Lares, PR 00669-1427

Mailing address

PO Box 1427
Lares, PR 00669-1427
Phone (787) 897-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080306000605 PR Part B Supplier - Clinic/Group Practice 8527054477 Receives reassigned benefits from 3 practitioners
Practice locations: Lares, PR

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Lares Medical Group Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1477580496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1427",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006691427",
            "telephone_number": "787-897-1444",
            "fax_number": "787-897-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 111 KM 2.9 AVE LOS PATRIOTAS",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006691427",
            "telephone_number": "787-897-1444",
            "fax_number": "787-897-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARES MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "BALTAZAR",
        "authorized_official_first_name": "RODRIGUEZ CRUZ",
        "authorized_official_title_or_position": "MEDICO",
        "authorized_official_telephone_number": "787-897-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "PR",
            "license": "119",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "PR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.