Bella Vista Hospital, Inc

Organization Active NPI Family Medicine Physician · Mayaguez, PR

NPI 1881998334 · NPPES record last updated Oct 2, 2024

Key facts

NPI
1881998334
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BELLA VISTA HOSPITAL, INC
Practice address
349 St. KM 3.4
Mayaguez, PR 00680
Phone
(787) 834-6000
Fax
(787) 805-3705
NPI assigned
Dec 27, 2010
Organization subpart
Yes
Parent organization (as reported)
BELLA VISTA HOSPITAL, INC

Authorized official

Name
Mr. Luis Rivera, MBA
Title
Director
Phone
(787) 834-6000

Other NPIs with the same Medicare PAC ID 5

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

Corporate family (same tax ID) 10

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

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110118000267 PR Part B Supplier - Clinic/Group Practice 6507831351 Receives reassigned benefits from 13 practitioners
Practice locations: Mayaguez, PR

National Provider Directory

Tax ID family
Bella Vista Hospital Inc (11 organizations share this tax ID)
Part of
Bella Vista Hospital Inc

Locations

770 Ave Hostos
#M
Mayaguez, PR 00682

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TC0700X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X

Addresses

Primary practice location

349 St. KM 3.4
Mayaguez, PR 00680

Mailing address

PO Box 1750
Mayaguez, PR 00681-1750
Phone (787) 834-6000

Other names

  • Bella Vista Family Medicine Doing business as

Other providers in Mayaguez, PR

All providers in Mayaguez, PR · Family Medicine Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.