NPIMap

Organization Active NPI

Puerto Rican Organization to Motivate Enlighten and Serve Addicts Inc

Doing business as PROMESA Inc

  • Methadone Clinic
  • Bronx, NY
National Provider Identifier
1508849993
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS INC
Doing business as
PROMESA Inc
Practice address
1776 Clay Avenue
Bronx, NY 10457
Phone
(718) 299-1100
Fax
(718) 716-7822
NPI assigned
Nov 21, 2005
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Vicky Gatell
Title
Chief Financial Officer
Phone
(718) 960-7568

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NY Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 170912043 NY

Addresses

Primary practice location

1776 Clay Avenue
Bronx, NY 10457

Mailing address

311 E 175TH St
Bronx, NY 10457-5859
Phone (718) 960-7568

Other practice location 1

754 E 151st St
Bronx, NY 10455-3267
Phone (347) 352-2500

Other identifiers 1

IdentifierTypeStateIssuer
02999571MedicaidNY

Other names 1

  • PROMESA Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040315000368 NY Part B Supplier - Clinic/Group Practice 5395634539 Receives reassigned benefits from 6 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY
O20200218000961 NY Part B Supplier - Opioid Treatment Program (Otp) 5395634539 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, NY; Bronx, NY; Brooklyn, NY; Buffalo, NY; Dunkirk, NY

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Promesa Inc

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1508849993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E 175TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104575859",
            "telephone_number": "718-960-7568",
            "fax_number": "718-716-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 CLAY AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-299-1100",
            "fax_number": "718-716-7822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "754 E 151st St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104553267",
            "country_code": "US",
            "telephone_number": "347-352-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS INC",
        "enumeration_date": "2005-11-21",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "GATELL",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-960-7568"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "170912043",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02999571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROMESA Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROMESA Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.