NPIMap

Organization Active NPI

Laboratorio Clinico CDT Dr. Jose Lopez Antongiorgi

  • Clinical Medical Laboratory
  • San Juan, PR
National Provider Identifier
1811267974
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1192 Issued in PR
Legal business name
LABORATORIO CLINICO CDT DR. JOSE LOPEZ ANTONGIORGI
Practice address
Calle 25 NE 333 Puerto Nuevo
San Juan, PR 00920-2531
Phone
(787) 480-5240
Fax
(787) 977-0544
NPI assigned
Jan 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Authorized official

Name
Dr. Luis V Clas, MD
Title
Executive Director/Ceo
Phone
(787) 480-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1192 PR Primary

Addresses

Primary practice location

Calle 25 NE 333 Puerto Nuevo
San Juan, PR 00920-2531

Mailing address

Calle 25 NE 333 Puerto Nuevo
San Juan, PR 00920-2531
Phone (787) 480-5040

Other identifiers 1

IdentifierTypeStateIssuer
037747100MedicaidPR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109000215 PR Part A Provider - Hospital 5597711945 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Juan, PR

Hospital certification: CCN 400015

Legal name
MUNICIPALITY OF SAN JUAN PR
Doing business as
SAN JUAN MUNICIPALITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 1, 2023
Beds
450
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Enrollment address
Bo Monacillos Centro Medico Rio Piedras
San Juan, PR 926
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 15

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

View all 15

Care Compare: Hospital

Medicare Care Compare
Listed as
San Juan Municipality HospitalCCN 400015
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
CDT Dr a J Garcia63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

178 Calle Victor a Fernandez
San Juan, PR 00927
Phone (787) 765-4881

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Luis V Clas Individual Corporate Officer Jan 11, 2021
Corporate Director Jan 11, 2021
W-2 Managing Employee Jan 11, 2021

Owners & managing parties with NPI records 1

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

  • Luis V Clas, M.D.
    • Emergency Medicine Physician
    • San Juan, PR
    • NPI 1497733349

    Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1811267974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE 25 NE 333 PUERTO NUEVO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009202531",
            "telephone_number": "787-480-5040",
            "fax_number": "787-977-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 25 NE 333 PUERTO NUEVO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009202531",
            "telephone_number": "787-480-5240",
            "fax_number": "787-977-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO CDT DR. JOSE LOPEZ ANTONGIORGI",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "CLAS",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "787-480-3838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037747100",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.