NPIMap

Organization Active NPI

Metro Pavia at Home LLC

Doing business as Metro Pavia @ Home - Mayaguez

  • Home Health Agency
  • San Juan, PR
National Provider Identifier
1487068375
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
METRO PAVIA AT HOME LLC
Doing business as
Metro Pavia @ Home - Mayaguez
Practice address
Plaza Monserrate IV
Carr 345 KM 2.1 Interseccion Carr PR 2 KM 2.0 Barrio la
San Juan, PR 00660-8606
Phone
(787) 833-1985
Fax
(787) 705-6794
NPI assigned
Jun 18, 2014
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Mrs. Lisandra Velez
Title
Executive Director
Phone
(787) 705-6982

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

Plaza Monserrate IV
Carr 345 KM 2.1 Interseccion Carr PR 2 KM 2.0 Barrio la
San Juan, PR 00660-8606

Mailing address

PO Box 11938
San Juan, PR 00922-1938
Phone (787) 705-6982

Other names 1

  • Metro Pavia @ Home - Mayaguez Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140820001904 PR Part A Provider - Home Health Agency 1557589363 Practice locations: Hormigueros, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487068375. Details of each certification follow.

Home health agency certification: CCN 407314

Legal name
METRO PAVIA AT HOME, LLC
Doing business as
METRO PAVIA @ HOME - MAYAGUEZ
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 18, 1978
Last certification
Sep 30, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Mar 28, 2014 in PR
Enrollment address
Plaza Monserrate IV Carr 345 KM 2.1 Int Carr PR 2
KM 2.0 Bo Lauadero
Hormigueros, PR 00660

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Metro Pavia @ Home- MayaguezCCN 407314 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Jul 18, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Metro Pavia Home11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Maria I Alvarez Betancourt Individual Corporate OfficerCorporate Associate Administrato Mar 1, 2022 100%
W-2 Managing EmployeeCorporate Associate Administrato Mar 1, 2022 100%
Artau Holdings III LLC Organization, Guaynabo, PR Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2016 100%
Johny Arzola Mangual Individual Corporate Director Jun 1, 2014 10%
W-2 Managing Employee Jun 1, 2014 10%
Leticia Velazquez-Irizarry Individual W-2 Managing EmployeeAdministrator Apr 8, 2019
Carmen Feliciano Vargas Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 38%
Eduardo J Artau Gomez Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 36%
Corporate OfficerPresident Jan 1, 2016 100%
Operational/Managerial Control Jan 1, 2016 100%
Karen Z Artau Feliciano Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 8%
Dalmarie Reyes-Sanabria Individual W-2 Managing EmployeeBilling Manager Sep 30, 2019
Lisandra Velez Gonzalez Individual Corporate OfficerChief Executive Officer Jun 1, 2023
Corporate DirectorChief Executive Officer Jun 1, 2023
W-2 Managing EmployeeChief Executive Officer Jun 1, 2023
Operational/Managerial ControlChief Executive Officer Jun 1, 2023
Eduardo Artau Feliciano Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 8%
Nilmar C Maldonado-Martinez Individual W-2 Managing EmployeeQuality and Case Management Mana Sep 30, 2019
Laura I Sola Individual Corporate DirectorFinance Director Jun 30, 2020 10%
W-2 Managing EmployeeFinance Director Jun 30, 2020 25%
Francisco Artau Feliciano Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 8%

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1487068375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11938",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009221938",
            "telephone_number": "787-705-6982",
            "fax_number": "787-705-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA MONSERRATE IV",
            "address_2": "CARR 345 KM 2.1 INTERSECCION CARR PR 2 KM 2.0 BARRIO LA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "006608606",
            "telephone_number": "787-833-1985",
            "fax_number": "787-705-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO PAVIA AT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-18",
        "last_updated": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "VELEZ",
        "authorized_official_first_name": "LISANDRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-705-6982",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Pavia @ Home - Mayaguez",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.