NPIMap

Organization Active NPI

Hospital Menonita Guayama Inc

Doing business as Hospital Menonita de Guayama

  • Critical Access Hospital
  • Guayama, PR
National Provider Identifier
1639696289
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
17-086 Issued in PR
Legal business name
HOSPITAL MENONITA GUAYAMA INC
Doing business as
Hospital Menonita de Guayama
Practice address
Urb. la Hacienda Albizu Campos
Esquina Principal
Guayama, PR 00784-0011
Phone
(787) 434-1700
Fax
(787) 434-1714
NPI assigned
Aug 24, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Lissette Vazquez Rivera
Title
Billing and Coding Manager
Phone
(787) 434-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 17-086 PR Primary

Addresses

Primary practice location

Urb. la Hacienda Albizu Campos
Esquina Principal
Guayama, PR 00784-0011

Mailing address

PO Box 1650
Cidra, PR 00739-1650
Phone (787) 434-1700

Other identifiers 1

IdentifierTypeStateIssuer
400048MedicaidPR

Other names 1

  • Hospital Menonita de Guayama Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180222000007 PR Part A Provider - Hospital 6507127180 Practice locations: Guayama, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639696289. Details of each certification follow.

Hospital certification: CCN 400048

Legal name
HOSPITAL MENONITA GUAYAMA INC
Doing business as
HOSPITAL MENONITA DE GUAYAMA
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 15, 2026
Beds
230 (161 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 15, 2016 in PR
Enrollment address
Ave. Pedro Albizu Campos
Urb. la Hacienda
Guayama, PR 7850001
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Hospital Menonita GuayamaCCN 400048 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Farmacia de la Comunidad Hospital Menonita de Guayama4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Lymari Colon Colon Individual Corporate DirectorCfo Nov 1, 2019 100%
W-2 Managing EmployeeCfo Nov 1, 2019 100%
Jose Veguilla Cartagena Individual Corporate OfficerCorporate Treasurer Sep 13, 2017
Lissette Vasquez Rivera Individual Corporate OfficerDir of Billing and Collection Sep 13, 2017 100%
W-2 Managing EmployeeDir of Billing and Collection Sep 13, 2017 100%
Jose Solivan Rivera Individual Corporate DirectorAssociate Ceo Sep 13, 2017 100%
W-2 Managing EmployeeAssociate Ceo Sep 13, 2017 100%
Ricardo Hernandez Rivera Individual Corporate OfficerAceo Sep 13, 2017
Corporate DirectorCeo Nov 1, 2019 100%
W-2 Managing Employee Nov 1, 2019 100%
Gerson Jimenez Catanon Individual Corporate DirectorMedical Director Sep 13, 2017
Robert Miller Eimen Individual Corporate OfficerVP Sep 13, 2017
Larry Bonilla Sauder Individual Corporate OfficerCorporate Secretary Sep 13, 2017
Rogelio Garcia Diaz Individual Corporate DirectorAdministrator Sep 13, 2017
W-2 Managing EmployeeAdministrator Sep 13, 2017

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 32

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 32

Affiliated clinicians 38

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1639696289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1650",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007391650",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. LA HACIENDA ALBIZU CAMPOS",
            "address_2": "ESQUINA PRINCIPAL",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007840011",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL MENONITA GUAYAMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ RIVERA",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "BILLING AND CODING MANAGER",
        "authorized_official_telephone_number": "787-434-1700"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "PR",
            "license": "17-086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400048",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospital Menonita de Guayama",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guayama, PR

Sources for this page

Verify at the official NPI Registry.