Metro Pavia at Home LLC
Organization Active NPI Home Health Agency · San Juan, PR
NPI 1487068375 · NPPES record last updated Apr 29, 2024
Key facts
- NPI
- 1487068375
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- METRO PAVIA AT HOME LLC
- 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
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lisandra Velez
- Title
- Executive Director
- Phone
- (787) 705-6982
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 10
Facilities with the same owner 1
Medicare Care Compare: Home health agency
- Listed as
- Metro Pavia @ Home- Mayaguez
- Overall star rating
- ★★★★★ 5 of 5
- Ownership
- Proprietary
- Certified
- Jul 18, 1978
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
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
- LLC · Proprietary
- 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
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Maria I Alvarez Betancourt |
Corporate Officer |
Mar 1, 2022 | 100% |
| W-2 Managing Employee |
Mar 1, 2022 | 100% | |
| Artau Holdings III LLC |
5% Or Greater Direct Ownership Interest | Jan 1, 2016 | 100% |
| Johny Arzola Mangual |
Corporate Director | Jun 1, 2014 | 10% |
| W-2 Managing Employee | Jun 1, 2014 | 10% | |
| Leticia Velazquez-Irizarry |
W-2 Managing Employee |
Apr 8, 2019 | |
| Carmen Feliciano Vargas |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 38% |
| Eduardo J Artau Gomez |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 36% |
| Corporate Officer |
Jan 1, 2016 | 100% | |
| Operational/Managerial Control | Jan 1, 2016 | 100% | |
| Karen Z Artau Feliciano |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 8% |
| Dalmarie Reyes-Sanabria |
W-2 Managing Employee |
Sep 30, 2019 | |
| Lisandra Velez Gonzalez |
Corporate Officer |
Jun 1, 2023 | |
| Corporate Director |
Jun 1, 2023 | ||
| W-2 Managing Employee |
Jun 1, 2023 | ||
| Operational/Managerial Control |
Jun 1, 2023 | ||
| Eduardo Artau Feliciano |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 8% |
| Nilmar C Maldonado-Martinez |
W-2 Managing Employee |
Sep 30, 2019 | |
| Laura I Sola |
Corporate Director |
Jun 30, 2020 | 10% |
| W-2 Managing Employee |
Jun 30, 2020 | 25% | |
| Francisco Artau Feliciano |
5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 8% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140820001904 | PR | Part a Provider - Home Health Agency | 1557589363 | Practice locations: Hormigueros, PR |
National Provider Directory
- Tax ID family
- Metro Pavia at Home LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037552400 | Medicaid | PR |
Other names
- Metro Pavia @ Home - Mayaguez
Other providers in San Juan, PR
- Metro Healthcare Management System
- Metro Medical Caribbean Center
- Metro Medical Caribbean Center, Inc
- Metro OB GYN PSC
- Metro Optical Group Inc
- Metro Pavia at Home LLC
- Metro Pavia at Home, LLC
- Metro Pediatrics LLC
- Metro Pharmacie, Inc.
- Metro Pharmacy, Inc.
All providers in San Juan, PR · Home Health 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 Apr 29, 2024. 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.