NPIMap

Organization Active NPI

Athletic Training and Rehab Center LLC

  • Rehabilitation Clinic/Center
  • Bayamon, PR
National Provider Identifier
1780123117
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
1923 Issued in PR
Legal business name
ATHLETIC TRAINING AND REHAB CENTER LLC
Practice address
BH 9 Calle Quintana Santa Juanita
Bayamon, PR 00956-4656
Phone
(939) 264-1889
Fax
(787) 395-7972
NPI assigned
Feb 17, 2017
Last updated
Aug 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Authorized official

Name
Mario CanalesNPI 1851783856
Title
President
Phone
(787) 484-9505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 1923 PR Primary

Addresses

Primary practice location

BH 9 Calle Quintana Santa Juanita
Bayamon, PR 00956-4656

Mailing address

BH 9 Calle Quintana Santa Juanita
Bayamon, PR 00956-4656
Phone (939) 264-1889

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190711000898 PR Part B Supplier - Clinic/Group Practice 4486989548 Receives reassigned benefits from 7 practitioners
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory

Locations

BH9 Calle Quintana
Bayamon, PR 00956
Phone (939) 264-1889

Practitioners & affiliated clinicians

Practitioners 12

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": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1780123117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BH 9 CALLE QUINTANA SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564656",
            "telephone_number": "939-264-1889",
            "fax_number": "787-395-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BH 9 CALLE QUINTANA SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564656",
            "telephone_number": "939-264-1889",
            "fax_number": "787-395-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC TRAINING AND REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "CANALES",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-484-9505"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "PR",
            "license": "1923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.