NPIMap

Organization Active NPI

Med Centro Inc.

  • Federally Qualified Health Center (FQHC)
  • Juana Diaz, PR
National Provider Identifier
1760755276
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MED CENTRO INC.
Practice address
Road 1, KM 9 Sector Capitanejo Singapur
Juana Diaz, PR 00795
Phone
(787) 843-9393
Fax
(787) 841-0077
NPI assigned
Feb 14, 2012
Last updated
Jul 17, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
MED CENTRO INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Authorized official

Name
Allan Cintron-Solichs, MBA, MHCM
Title
Executive Director
Phone
(787) 843-9393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

Road 1, KM 9 Sector Capitanejo Singapur
Juana Diaz, PR 00795

Mailing address

PO Box 220
Mercedita, PR 00715-0220
Phone (787) 843-9393

Other names 1

  • Consejo de Salud de Puerto Rico, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031216000213 PR Part B Supplier - Clinic/Group Practice 5890692131 Receives reassigned benefits from 92 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ponce, PR; Villalba, PR; Penuelas, PR; Juana Diaz, PR; Coamo, PR
O20141110000310 PR Part A Provider - Federally Qualified Health Center (FQHC) 5890692131 Practice locations: Juana Diaz, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760755276. Details of each certification follow.

Federally qualified health center certification: CCN 401821

Legal name
MED CENTRO INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 20, 2014
Last certification
Nov 20, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 4, 1971 in PR
Enrollment address
Carr. 1 KM 135.5, Bo
Capitanejo Sector Singapur
Juana Diaz, PR 795

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Cto Cir Ambul Playa Ponce28 organizations share this tax ID, including this one
Part of
Cto Cir Ambul Playa Ponce

Other organizations with this tax ID 27

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

View all 27

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Carmen Cruz-Cancel Individual Corporate DirectorVocal Feb 28, 2018
Allan Cintron-Salichs Individual Corporate DirectorExecutive Director Mar 16, 2006
W-2 Managing EmployeeExecutive Director Mar 16, 2006
Samuel Santos Rivera Individual Corporate DirectorVocal-Board of Directors Aug 23, 2023
Maria Roque-Torruella Individual Corporate DirectorSecretary Board of Directors Sep 6, 2011
Sol Belfort-Maldonado Individual Corporate DirectorVocal Sep 26, 2012
Jorge Morales Torres Individual Corporate DirectorVocal-Board of Directors Jan 27, 2021
Jose O Coll-Diaz Individual Corporate DirectorLegal Counsel Aug 28, 2009
Pedro Velez Acosta Individual Corporate DirectorVocal Nov 2, 2005
Jaime Garcia-Ramirez Individual Corporate DirectorVocal Jan 1, 2008
Marilyn Santiago Ayala Individual Corporate DirectorVocal-Board of Directors Mar 31, 2021
Gladys Santos-Cintron Individual Corporate DirectorVP Board of Director Jan 1, 1988
Victor Montalvo-Martell Individual Corporate DirectorTesouro Board of Directors Jan 1, 2008
Ileana Yambo Febus Individual Corporate DirectorVocal-Board of Directors Mar 31, 2021
Eduardo Martinez-Tull Individual Corporate DirectorPresident Board of Directors Jan 1, 2005
Ramberto Rivera Oliveras Individual Corporate DirectorVocal-Board of Directors Apr 24, 2024
Ivan Madera Rodríguez Individual Corporate DirectorVocal-Board of Directors Feb 23, 2023

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1760755276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "MERCEDITA",
            "state": "PR",
            "postal_code": "007150220",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROAD 1, KM 9 SECTOR CAPITANEJO SINGAPUR",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "00795",
            "telephone_number": "787-843-9393",
            "fax_number": "787-841-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED CENTRO INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED CENTRO INC.",
        "enumeration_date": "2012-02-14",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "CINTRON-SOLICHS",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-843-9393",
        "authorized_official_credential": "MBA, MHCM"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Consejo de Salud de Puerto Rico, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Juana Diaz, PR

Sources for this page

Verify at the official NPI Registry.