NPIMap

Organization Active NPI

Puerto Rican Organization to Motivate Enlighten and Serve Addicts, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dunkirk, NY
National Provider Identifier
1558028126
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS, INC
Practice address
303 Main St
Dunkirk, NY 14048-2718
Phone
(716) 413-4661
NPI assigned
Nov 18, 2021
Last updated
Nov 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Authorized official

Name
Vicky Gatell
Title
Cfo
Phone
(718) 960-7629

Specialties & licenses 2

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

Addresses

Primary practice location

303 Main St
Dunkirk, NY 14048-2718

Mailing address

1776 Clay Ave
Bronx, NY 10457-7299
Phone (718) 299-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 5

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

National Provider Directory

National Provider Directory
Tax ID family
Promesa Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

303 Main St
Dunkirk, NY 14048
Phone (716) 413-4661

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1558028126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 CLAY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577299",
            "telephone_number": "718-299-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MAIN ST",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482718",
            "telephone_number": "716-413-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "GATELL",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-960-7629"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.