Hospicio San Francisco de Asis, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

24 Issued in PR

Legal business name

HOSPICIO SAN FRANCISCO DE ASIS, INC.

Practice address

Carr 441 KM 4.6
Bo. Guaniquilla
Aguada, PR 00602

Phone

(787) 868-2920

Fax

(787) 252-0211

NPI assigned

Jul 26, 2006

Last updated

Sep 22, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

HOSPICIO SAN FRANCISCO DE ASIS, INC.As reported in NPPES

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

Authorized official

Name

Ennelly Cofresi

Title

Executive Director

Phone

(787) 868-2920

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508889825. Details of each certification follow.

• CCN 401551 Hospice · Active · Details

Hospice certification: CCN 401551

Legal name

HOSPICIO SAN FRANCISCO DE ASIS INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 24, 1995

Last certification

Mar 11, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Apr 6, 1993 in PR

Enrollment address

Carr 441, KM 0.4
Bo. Guaniquilla
Aguada, PR 00602-0877

Listed as

Hospicio San Francisco de Asis IncCCN 401551 · All quality measures

Ownership

For-Profit

Certified

Apr 24, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Part of

Hospicio San Francisco de Asis Inc

All disclosed owners & managing parties 6

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Freddy Quinones Caraballo, MD

  • General Practice Physician
  • Aguada, PR
  • NPI 1528127032

  5% Or Greater Direct Ownership Interest, Corporate Director

  CMS ownership
• Evaristo Quinones Ruiz, M.D.

  • General Practice Physician
  • Aguada, PR
  • NPI 1932255353

  5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

  CMS ownership

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.

• Evaristo Quinones Ruiz, M.D.

  • General Practice Physician
  • Aguada, PR
  • NPI 1932255353

  Family Medicine

  NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1508889825",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "BO GUANIQUILLA CARR 441 KM 4.6",
            "city": "AGUADA",
            "state": "PUERTO RICO",
            "postal_code": "00602",
            "telephone_number": "787-868-2920",
            "fax_number": "787-252-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 441 KM 4.6",
            "address_2": "BO. GUANIQUILLA",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "787-868-2920",
            "fax_number": "787-252-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICIO SAN FRANCISCO DE ASIS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPICIO SAN FRANCISCO DE ASIS, INC.",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "COFRESI",
        "authorized_official_first_name": "ENNELLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-868-2920"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PR",
            "license": "24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "401551",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anabel Hernandez-Mantilla, PT
• Marie Bernadine Hidalgo - Rivera, MD
• Edwin Hilerio Ramos, DC
• Hilerios Chiropractic LLC
• Home Psychiatric Service Corp
• Hospicio Santa Rita, Inc.
• Hu-Mind LLC
• Nilbeth Carolina Hurtado Guevara, M.D.
• Inmuni, LLC
• Innovus Therapy Group LLC

• Community Based Hospice Care Agency in Aguada, PR
• Providers in Aguada, PR by specialty
• Community Based Hospice Care Agency in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.