NPIMap

Organization Active NPI

Camino de Luz Hospice Care Inc

  • Community Based Hospice Care Agency
  • Manati, PR
National Provider Identifier
1851377592
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CAMINO DE LUZ HOSPICE CARE INC
Practice address
Barriada Felix Cordaba Davila #13
Manati, PR 00674
Phone
(787) 884-0786
NPI assigned
Dec 15, 2005
Last updated
Feb 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Authorized official

Name
Manuel Santiago Concepcion
Title
Director Ejecutivo
Phone
(787) 884-0786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

Barriada Felix Cordaba Davila #13
Manati, PR 00674

Mailing address

PO Box 3446
Manati, PR 00674-3446
Phone (787) 884-4668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130329000074 PR Part A Provider - Hospice 0547405227 Practice locations: Manati, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851377592. Details of each certification follow.

Hospice certification: CCN 401558

Legal name
CAMINO DE LUZ HOSPICE CARE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 28, 2000
Last certification
Oct 21, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationProprietary
Incorporated
Jun 2, 2006 in PR
Enrollment address
Bo Cotto Norte Interior
Carr 670 KM 1.8
Manati, PR 00674-3446

Care Compare: Hospice

Medicare Care Compare
Listed as
Camino de Luz Hospice CareCCN 401558 · All quality measures
Ownership
For-Profit
Certified
Apr 28, 2000
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Robin Santiago Delgado Individual Corporate DirectorMedical Director Jan 1, 2011
Manuel Santiago Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Jun 20, 2006 60%
Corporate OfficerPresident Jun 20, 2006 60%
Corporate DirectorChief Executive Officer Jun 20, 2006 60%
W-2 Managing EmployeeChief Executive Officer Jun 20, 2006 60%
Manuel Santiago Carrion Individual Operational/Managerial ControlAdministrator Mar 25, 2013
Nancy E Serpa Individual 5% Or Greater Direct Ownership InterestService Director Jun 20, 2006 40%
Corporate OfficerSecretary Jun 20, 2006 40%
Corporate DirectorServices Director Jun 20, 2006 40%
W-2 Managing EmployeeServices Director Jun 20, 2006 40%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1851377592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3446",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006743446",
            "telephone_number": "787-884-4668",
            "fax_number": "787-884-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BARRIADA FELIX CORDABA DAVILA #13",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-884-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMINO DE LUZ HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "CONCEPCION",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "SANTIAGO",
        "authorized_official_title_or_position": "DIRECTOR EJECUTIVO",
        "authorized_official_telephone_number": "787-884-0786"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.