Organization Active NPI

Clinica Yaguez Inc

Doing business as Pavia Health Clinic Guanica

  • Emergency Medical Services (Emergency Medicine) Physician
  • Guanica, PR
National Provider Identifier
1811455413
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
CLINICA YAGUEZ INC
Doing business as
Pavia Health Clinic Guanica
Practice address
Carr 116 Ramal 1116 KM 27.7
Guanica, PR 00653
Phone
(787) 821-0402
Fax
(787) 805-2840
NPI assigned
Mar 4, 2019
Last updated
Apr 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Mr. Carlos I Huertas
Title
Finance Director
Phone
(787) 832-8444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU Primary

Addresses

Primary practice location

Carr 116 Ramal 1116 KM 27.7
Guanica, PR 00653

Mailing address

PO Box 698
Mayaguez, PR 00681-0698
Phone (787) 832-8444

Other names 1

  • PAVIA HEALTH CLINIC GUANICA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100525000259 PR Part B Supplier - Clinic/Group Practice 9830175033 Receives reassigned benefits from 61 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mayaguez, PR

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

117 Calle Ramon Valdes
Mayaguez, PR 00680
Phone (787) 832-8445

Practitioners & affiliated clinicians

Practitioners 7

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": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1811455413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810698",
            "telephone_number": "787-832-8444",
            "fax_number": "787-805-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 116 RAMAL 1116 KM 27.7",
            "city": "GUANICA",
            "state": "PR",
            "postal_code": "00653",
            "telephone_number": "787-821-0402",
            "fax_number": "787-805-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA YAGUEZ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "HUERTAS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "787-832-8444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAVIA HEALTH CLINIC GUANICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guanica, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.