Active NPI
St Lukes Episcopal Church Home Care Program
Doing business as St. Lukes Home Health Agency Bayamon
- Home Health Agency
- Bayamon, PR
National Provider Identifier
1619961877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 30
- Legal business name
- ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM
- Doing business as
- St. Lukes Home Health Agency Bayamon
- Practice address
- Royal Club Convention Center 2Ndo Piso
Ave. Comerio Carr. 167 KM. 19.5
Bayamon, PR 00958 - Phone
- (787) 843-4185
- Fax
- (787) 843-5850
- NPI assigned
- Sep 2, 2005
- Last updated
- Dec 16, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Isuanet Castillo, CPA
- Title
- Operational Executive Director
- Phone
- (787) 843-4185
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 30 | PR | Primary |
Addresses
Primary practice location
Royal Club Convention Center 2Ndo Piso
Ave. Comerio Carr. 167 KM. 19.5
Bayamon, PR 00958
Mailing address
Aptdo 4118
Bayamon Gardens Station
Bayamon, PR 00958
Phone (787) 843-4185
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9800093 | Other | PA | ACAA |
| 071002 | Other | PR | CRUZ AZUL |
| 1-9485ST | Other | PR | TRIPLE S |
| 7330102 | Other | PR | HUMANA |
Other names 1
- St. Lukes Home Health Agency Bayamon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider DirectoryOwnership & related parties
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Apr 1, 2022 | Change of Ownership | Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas Inc |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
- Home Health Agency
- Bayamon, PR
- NPI 1558096875
Sold to, 2022-04-01
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125619200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1323993600000",
"number": "1619961877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "APTDO 4118",
"address_2": "BAYAMON GARDENS STATION",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00958",
"telephone_number": "787-843-4185",
"fax_number": "787-843-5850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ROYAL CLUB CONVENTION CENTER 2NDO PISO",
"address_2": "AVE. COMERIO CARR. 167 KM. 19.5",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00958",
"telephone_number": "787-843-4185",
"fax_number": "787-843-5850"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-02",
"last_updated": "2011-12-16",
"status": "A",
"authorized_official_last_name": "CASTILLO",
"authorized_official_first_name": "ISUANET",
"authorized_official_title_or_position": "OPERATIONAL EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "787-843-4185",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "PR",
"license": "30",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACAA",
"identifier": "9800093",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRUZ AZUL",
"identifier": "071002",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIPLE S",
"identifier": "1-9485ST",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "7330102",
"state": "PR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Lukes Home Health Agency Bayamon",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.