NPIMap

Organization Active NPI

Mediko Medicina Primaria Corp

  • Primary Care Clinic/Center
  • Caguas, PR
National Provider Identifier
1609096981
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MEDIKO MEDICINA PRIMARIA CORP
Practice address
Hosp Hima
Medicina de Familia
Caguas, PR 00726-7589
Phone
(787) 653-5353
Fax
(787) 653-5364
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Miss Vanessa Perez
Title
Director
Phone
(787) 653-5353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

Hosp Hima
Medicina de Familia
Caguas, PR 00726-7589

Mailing address

PO Box 7589
Caguas, PR 00725-7589
Phone (787) 653-5353

Other practice location 1

51 Calle Manuel Corchado
Cayey, PR 00736-3811
Phone (787) 738-8470

Other identifiers 2

IdentifierTypeStateIssuer
2700373OtherPRHUMANA PRIVADO
6250068OtherPRHUMANA GOLD PLUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221104001869 PR Part B Supplier - Clinic/Group Practice 5991172843 Receives reassigned benefits from 11 practitioners
Practice locations: Caguas, PR; Humacao, PR; Cayey, PR

National Provider Directory

National Provider Directory
Tax ID family
Mediko Medicina Primaria Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2 Calle Dufresne W
Humacao, PR 00791
Phone (787) 665-0388

2 Calle Dufresne W
Humacao, PR 00791

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1609096981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7589",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007257589",
            "telephone_number": "787-653-5353",
            "fax_number": "787-653-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSP HIMA",
            "address_2": "MEDICINA DE FAMILIA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007267589",
            "telephone_number": "787-653-5353",
            "fax_number": "787-653-5364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Calle Manuel Corchado",
            "address_purpose": "LOCATION",
            "city": "Cayey",
            "state": "PR",
            "postal_code": "007363811",
            "country_code": "US",
            "telephone_number": "787-738-8470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDIKO MEDICINA PRIMARIA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-653-5353",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA PRIVADO",
            "identifier": "2700373",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD PLUS",
            "identifier": "6250068",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.