Hospicio Divino Salvador, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

31 Issued in PR

Legal business name

HOSPICIO DIVINO SALVADOR, INC.

Practice address

Carr. 2 KM. 40.2 Plaza Jardines
Suite 8
Vega Baja, PR 00693

Phone

(787) 855-0411

Fax

(787) 855-0285

NPI assigned

Mar 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Guillermo Reyes

Title

Executive Director

Phone

(787) 855-0411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Hospice certification: CCN 401562

Legal name

HOSPICIO DIVINO SALVADOR, INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 24, 2001

Last certification

Mar 20, 2019

Ownership / control type

Non-Profit - Private

Organization structure

CorporationProprietary

Enrollment address

Calle Marginal PR-2 Esquina Con la Calle Julian BL
Vega Baja, PR 00693

Listed as

Hospicio Divino Salvador, IncCCN 401562

Ownership

For-Profit

Certified

May 24, 2001

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Wilmer Rodriguez Diaz, M.D.

  • General Practice Physician
  • Corozal, PR
  • NPI 1154567493

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 2

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

• Jose Francisco De Leon, M.D.

  • Internal Medicine Physician
  • Vega Baja, PR
  • NPI 1184607988

  Hospice

  Care Compare affiliation
• Wilmer Rodriguez Diaz, M.D.

  • General Practice Physician
  • Corozal, PR
  • NPI 1154567493

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1699734707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006941450",
            "telephone_number": "787-855-0411",
            "fax_number": "787-855-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 2 KM. 40.2 PLAZA JARDINES",
            "address_2": "SUITE 8",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-855-0411",
            "fax_number": "787-855-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICIO DIVINO SALVADOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "GUILLERMO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-855-0411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "PR",
            "license": "31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Vega Baja, PR
• Providers in Vega Baja, PR by specialty
• Community Based Hospice Care Agency in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.
• 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.