Northeast Corp

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

31 Issued in PR

Legal business name

NORTHEAST CORP

Practice address

Ave 1 Santa Rita
Suite 304
Vega Alta, PR 00692-0000

Phone

(787) 270-1345

Fax

(787) 270-1350

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Jose Serrano, LIC

Title

Administrator

Phone

(787) 594-6383

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Listed as

Northeast CorpCCN 40C0001017

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Luis Viera-Caban, MD

  • Urology Physician
  • Manati, PR
  • NPI 1659449627
  NPD

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1669635397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE 1 URB SANTA RITA",
            "address_2": "OFFICE 304",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006920000",
            "telephone_number": "787-270-1345",
            "fax_number": "787-270-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE 1 SANTA RITA",
            "address_2": "SUITE 304",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006920000",
            "telephone_number": "787-270-1345",
            "fax_number": "787-270-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-594-6383",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LIC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PR",
            "license": "31",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LICENCE",
            "identifier": "31",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen M. Navedo-Rosado
• Mildred Negron Ocasio, RPH
• Carmen Alicia Nieves Vargas
• Deborah Nieves, M.S.
• North Medical Services LLC
• Wildalis Novoa-Vidot
• Nueva Farmacia Santa Ana, Inc.
• Nueva Vida de la Salud Corp
• Nueva Vida de la Salud Corp
• William A Nunez, DMD

• Ambulatory Surgical Clinic/Center in Vega Alta, PR
• Providers in Vega Alta, PR by specialty
• Ambulatory Surgical Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.