NPIMap

Organization Active NPI

Saint Lukes Memorial Hospital Inc

Doing business as Hospital San Lucas

  • General Acute Care Hospital
  • Ponce, PR
National Provider Identifier
1841295557
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
5 Issued in PR
Legal business name
SAINT LUKES MEMORIAL HOSPITAL INC
Doing business as
Hospital San Lucas
Practice address
917 Ave Tito Castro
Ponce, PR 00716-4717
Phone
(787) 844-2080
NPI assigned
Jun 17, 2005
Last updated
Aug 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Authorized official

Name
Mr. Ian Guillen, CPA
Title
Assistant Chief Financial Officer
Phone
(787) 844-2080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU
General Acute Care Hospital 282N00000X 5 PR Primary

Addresses

Primary practice location

917 Ave Tito Castro
Ponce, PR 00716-4717

Mailing address

PO Box 336810
Ponce, PR 00733-6810
Phone (787) 844-2080

Other identifiers 18

IdentifierTypeStateIssuer
19826OtherPRTRIPLE S
4855OtherPRIMC
31225OtherPRTRIPLE C
18020OtherPRTRIPLE S
18826OtherPRTRIPLE S
31247OtherPRTRIPLE S
66011960BOtherPRMCS
700009OtherPRMMM
92399OtherPRTRIPLE S
300115OtherPRUTI
5001587OtherPRACAA HOSP/ER
5501466OtherPRACAA ASC
10826OtherPRTRIPLE S
19020OtherPRTRIPLE S
31225OtherPRTRIPLE S
660191960OtherPRMAPFRE & OTHERS
304264OtherPRACAA TERAPIA FISICA
7310370OtherPRHUMANA

Other names 1

  • Hospital San Lucas Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20051007000794 PR Part B Supplier - Clinic/Group Practice 1456376599 Receives reassigned benefits from 30 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ponce, PR; San Juan, PR
O20080125000452 PR Part A Provider - Hospital 1456376599 Practice locations: Ponce, PR
O20210616002570 PR Part A Provider - Hospital 1456376599 Practice locations: Ponce, PR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1841295557. Details of each certification follow.

Hospital certification: CCN 400044

Legal name
SAINT LUKES MEMORIAL HOSPITAL INC
Doing business as
HOSPITAL EPISCOPAL SAN LUCAS II
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 14, 2023
Beds
427
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2000 in PR
Enrollment address
917 Ave Tito Castro
Ponce, PR 7164717
Main/Primary Hospital Location
Hospital subgroups
General

Hospital certification: CCN 40S044

Legal name
SAINT LUKES MEMORIAL HOSPITAL INC
Doing business as
CENTRO DE SALUD CONDUCTAL SAN LUCAS
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2000 in PR
Enrollment address
917 Ave Tito Castro
Ponce, PR 7164717
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Hospital Episcopal San Lucas IICCN 400044 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Servicios de Salud Episcopales, Inc. Organization, Ponce, PR Corporation, Management services company, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 1, 2000 100%
Operational/Managerial Control Sep 1, 2000 100%
5% Or Greater Direct Ownership Interest Sep 1, 2000 100%
Rafael L Morales Maldonado Individual Corporate DirectorPresident Board of Directors Jul 1, 2017
Corporate OfficerPresident Board of Director Jul 1, 2017
Edwin Velez Crespo Individual Corporate DirectorVice-Presidente Junta de Directo Dec 14, 2022
Corporate DirectorVice-Presidente Junta de Directores Dec 14, 2022
Rafael Alvarado Individual Corporate DirectorDirector Ejecutivo Operacional Oct 23, 2023
Juan a Salazar Trogolo Individual Corporate OfficerPrincipal Oficial Ejecutivo - Sse May 23, 2018
W-2 Managing EmployeePrincipal Oficial Ejecutivo - Sse May 23, 2018
Antonio Cruz Ortiz Individual Corporate DirectorBoard Member Jan 1, 2020
Other Jan 1, 2020
Emilia Morales Vega Individual Corporate DirectorBoard Member Jan 1, 2019
Other May 1, 2009
Ana M Lago Correa Individual Corporate DirectorBoard Member May 1, 2018
Other May 1, 2018
Julia Ramos Castillo Individual Corporate DirectorSecretary, Junta de Directores Feb 3, 2005 6.7%
Corporate DirectorSecretaria Junta de Directores Jan 1, 2000
Haedie Ramos Burgos Individual Corporate DirectorFinance Director Nov 13, 2023
W-2 Managing EmployeeFinance Director Nov 13, 2023
Luis Nieves Ramos Individual Corporate DirectorBoard Member Jan 1, 2015
Other Jan 1, 2015
Xiat Garcia Antongiorgi Individual Corporate DirectorBoard Member Jan 1, 2017
Adrian Rivera Molina Individual Corporate DirectorBoard Member Nov 1, 2023
Edgar E Domenech Fagundo Individual Corporate DirectorMedical Director Nov 1, 2019
W-2 Managing EmployeeMD; Nov 1, 2019
Corporate DirectorDirector Medico - Interino Dec 23, 2019
Sasha Chardon Perez Individual Corporate DirectorDirectora Ejecutiva Asociada Nov 27, 2023
Iglesia Episcopal Puertorriquena, Inc Organization, Trujillo Alto, PR Corporation, Holding company, Non-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2000 100%
Operational/Managerial Control Sep 1, 2000 100%
5% Or Greater Direct Ownership Interest Sep 1, 2000 100%
Anabelle Ortiz-Rivera Individual Corporate DirectorPresident of Medical Faculty Jan 1, 2024
Rosemary de la Cruz Severino Individual Corporate OfficerPrincipal Oficial Financiero Jan 1, 2018
W-2 Managing EmployeePrincipal Oficial Financiero Jan 1, 2018
Corporate OfficerPrincipal Oficial Financiera - Sse Jan 1, 2018
W-2 Managing EmployeePrincipal Oficial Financiera - Sse Jan 1, 2018

Owners & managing parties with NPI records 2

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 89

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.

View all 89

Affiliated clinicians 119

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

View all 119

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1841295557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336810",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007336810",
            "telephone_number": "787-844-2080",
            "fax_number": "787-844-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 AVE TITO CASTRO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164717",
            "telephone_number": "787-844-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LUKES MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "GUILLEN",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "ASSISTANT CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "787-844-2080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "PR",
            "license": "5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "19826",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMC",
            "identifier": "4855",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE C",
            "identifier": "31225",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "18020",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "18826",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "31247",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "66011960B",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "700009",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "92399",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTI",
            "identifier": "300115",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACAA HOSP/ER",
            "identifier": "5001587",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACAA ASC",
            "identifier": "5501466",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "10826",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "19020",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "31225",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAPFRE & OTHERS",
            "identifier": "660191960",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACAA TERAPIA FISICA",
            "identifier": "304264",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "7310370",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospital San Lucas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospital San Lucas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.