NPIMap

Organization Active NPI

Atlantis Health Care Group Puerto Rico, Inc.

Doing business as Renal Centre of San German

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San German, PR
National Provider Identifier
1871996728
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
46 Issued in PR
Legal business name
ATLANTIS HEALTH CARE GROUP PUERTO RICO, INC.
Doing business as
Renal Centre of San German
Practice address
Avenida Castro Perez PR-122 KM 0.6
Centro Commercial Las Lomas
San German, PR 00683-0000
Phone
(787) 292-7979
Fax
(787) 292-7999
NPI assigned
Oct 7, 2014
Last updated
Oct 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Authorized official

Name
Mrs. Rubette Harford
Title
President, Ceo
Phone
(787) 292-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 46 PR Primary

Addresses

Primary practice location

Avenida Castro Perez PR-122 KM 0.6
Centro Commercial Las Lomas
San German, PR 00683-0000

Mailing address

PMB 1350
St. Just Station
Trujillo Alto, PR 00978-1350
Phone (787) 292-7979

Other names 1

  • Renal Centre of San German Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140609000885 PR Part A Provider - End-Stage Renal Disease Facility (ESRD) 1951213172 1 other NPI on this enrollment
Practice locations: San German, PR

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Atlantis Health Care Group Puerto Rico Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1871996728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 1350",
            "address_2": "ST. JUST STATION",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009781350",
            "telephone_number": "787-292-7979",
            "fax_number": "787-292-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA CASTRO PEREZ PR-122 KM 0.6",
            "address_2": "CENTRO COMMERCIAL LAS LOMAS",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "006830000",
            "telephone_number": "787-292-7979",
            "fax_number": "787-292-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIS HEALTH CARE GROUP PUERTO RICO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "HARFORD",
        "authorized_official_first_name": "RUBETTE",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "787-292-7979",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PR",
            "license": "46",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Centre of San German",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San German, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.