Dialysis Access Center LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DIALYSIS ACCESS CENTER LLC

Practice address

357 Ave Hostos
Office Park II Suite 203
Mayaguez, PR 00680-1507

Phone

(847) 388-2065

Fax

(866) 720-9740

NPI assigned

Mar 13, 2008

Last updated

Oct 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lysa Jacks

Title

Credentialing Specialist

Phone

(847) 388-2065

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Justo Gonzalez-Trapaga, M.D.

  • Nephrology Physician
  • Hannibal, MO
  • NPI 1477553865
  NPD (past)

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1508037011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 AVE HOSTOS",
            "address_2": "OFFICE PARK II SUITE 203",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801507",
            "telephone_number": "847-388-2065",
            "fax_number": "866-720-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 AVE HOSTOS",
            "address_2": "OFFICE PARK II SUITE 203",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801507",
            "telephone_number": "847-388-2065",
            "fax_number": "866-720-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS ACCESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "JACKS",
        "authorized_official_first_name": "LYSA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "847-388-2065",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Departamento de Servicios Medicos Recinto Universitario de Mayaguez
• Ashwin V. Deshmukh, MD
• Cindy Yadira Despiau, SOCIAL WORKER
• Cesar A Detres, MD
• Diabetic Solutions Corp
• Diana Lopez (Isla Ambulance)
• Diana Lopez Soba (Isla Ambulance Service)
• Carlos David Diaz Perez, MD
• Dannel Diaz Ruiz, MD
• Juan R Diaz Troche Sr., MD

• Specialist in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Specialist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.