Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas, Inc.
Organization Active NPI Community Based Hospice Care Agency · Ponce, PR
NPI 1841925161 · NPPES record last updated Jul 26, 2022
Key facts
- NPI
- 1841925161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS, INC.
- Practice address
- 917 Ave Tito Castro
Building a, 4TH Floor
Ponce, PR 00716-4717 - Phone
- (787) 843-4185
- Fax
- (787) 843-5850
- NPI assigned
- Jul 20, 2022
- Organization subpart
- No
Authorized official
- Name
- Mrs. Isuanet Castillo Medina
- Title
- Directora Ejecutiva Operacional
- Phone
- (787) 843-4185
Owners & managing parties with NPI records 1
-
Angel Manuel Davila, M.D.
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 9
Change of ownership 1
Facilities with the same owner 9
Affiliated clinicians 82
-
Alberto Abreu-Rivera, M.D. FAMILY PHYSICIA
-
Lorieva Acevedo, MD
-
Anthony Agosto, MD
-
Balbino Ayala-Rosa, M.D.
-
Ismael Bague, M.D.
-
Juan Xavier Barreras, M.D.
-
Jorge Cedeno Espaillat, 17552
-
Jaquelin Colon Marin, M.D.
-
Lorna Elena Diaz Lozada, M.D.
-
Javier Rafael Espada, M.D.
-
Antonio Flores Torrent, M.D.
-
Ramon Gerena Sr., MD
-
Damarys Gonzalez, M.D.
-
Ruben Green Colon, M.D.
-
Andres Ivan Gutierrez, M.D.
Medicare Care Compare: Hospice
- Listed as
- Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas Inc
- Ownership
- Non-Profit
- Certified
- Jan 27, 1993
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Hospice certification: CCN 401530
- Legal name
- PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jan 27, 1993
- Last certification
- Sep 4, 2002
- Ownership / control type
- Non-Profit - Church
- Organization structure
- Corporation · Non-profit
- Incorporated
- Sep 1, 2000 in PR
- Enrollment address
- 917 Avenida Tito Castro-Carr 14
4TH FL Building a
Ponce, PR 00716-4717
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Servicios de Salud Episcopales, Inc. |
Operational/Managerial Control | Sep 1, 2000 | 100% |
| Evelyn Torres Rivera |
Corporate Director |
Sep 1, 2014 | |
| Rafael L Morales Maldonado |
Corporate Director |
Jul 1, 2017 | |
| Juan a Salazar Trogolo |
Corporate Officer |
May 23, 2018 | |
| W-2 Managing Employee |
May 23, 2018 | ||
| Emilia Morales Vega |
Corporate Director |
Jan 1, 2006 | |
| Francisco Otero |
Corporate Director |
Mar 18, 2024 | |
| W-2 Managing Employee |
Mar 18, 2024 | ||
| Ana M Lago Correa |
Corporate Director |
Jan 1, 2012 | |
| Fernando Nieves Camacho |
Corporate Director |
May 1, 2016 | |
| Isuanet Castillo Medina |
Corporate Officer |
Jul 3, 2008 | |
| W-2 Managing Employee |
Jul 3, 2008 | ||
| Iglesia Episcopal Puertorriquena, Inc |
5% Or Greater Direct Ownership Interest | Sep 1, 2000 | 100% |
| Angel Davila |
Contracted Managing Employee |
Mar 1, 2024 | |
| Corporate Director |
Mar 1, 2024 | ||
| Jose a Diaz Martinez |
Corporate Director |
May 1, 2018 | |
| Eileen I Torres Guadalupe |
Corporate Director |
Jul 8, 2024 | |
| W-2 Managing Employee |
Jul 8, 2024 | ||
| Rosemary de la Cruz Severino |
Corporate Officer |
Dec 14, 2018 | |
| W-2 Managing Employee |
Dec 14, 2018 | ||
| Lydia Colon Torres |
Corporate Director |
Aug 1, 2013 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Apr 1, 2022 | Change of Ownership |
St. Lukes Episcopal Church Home Care & Hospice Program |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220829000057 | PR | Part a Provider - Hospice | 3678957461 | Practice locations: Aguadilla, PR; Trujillo Alto, PR; Ponce, PR; Lares, PR; Bayamon, PR; Arecibo, PR; Caguas, PR |
National Provider Directory
- Tax ID family
- Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas Inc
Locations
917 Ave Tito Castro
Bldg A
Ponce, PR 00716
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
917 Ave Tito Castro
Building a, 4TH Floor
Ponce, PR 00716-4717
Mailing address
PO Box 7064
Ponce, PR 00732-7064
Phone (787) 843-4185
Other providers in Ponce, PR
- Professional Integrated Medical Solution,PSC
- Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas, Inc
- Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas, Inc
- Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas, Inc
- Programa de Servicios de Salud En El Hogar Y Hospicio San Lucas, Inc.
- Project Medical Supply Inc
- Psicsur
- Psyblum Psychological Service LLC
- Psyche, Servicios Psicologicos
- Psychiatrics PSC
All providers in Ponce, PR · Community Based Hospice Care Agency in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.