NPIMap

Organization Active NPI

Laboratorio Clinico Trixymar, Plaza del Mar

  • Clinical Medical Laboratory
  • Humacao, PR
National Provider Identifier
1891229092
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1283 Issued in PR
Legal business name
LABORATORIO CLINICO TRIXYMAR, PLAZA DEL MAR
Practice address
Carr PR3 KM 85.6 Bo Buena Vista
Edificio Plaz del Mar Local 12
Humacao, PR 00791
Phone
(787) 656-8673
NPI assigned
Apr 13, 2017
Last updated
Jun 14, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
TRIXYMAR INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Mr. Luis Diaz-Vega
Title
Administrador
Phone
(787) 861-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1283 PR Primary

Addresses

Primary practice location

Carr PR3 KM 85.6 Bo Buena Vista
Edificio Plaz del Mar Local 12
Humacao, PR 00791

Mailing address

PO Box 97
Maunabo, PR 00707-0097
Phone (787) 861-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110210000194 PR Part B Supplier - Independent Clinical Laboratory 8527248434 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arroyo, PR; Humacao, PR; Maunabo, PR

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Laboratorio Clinico Trixymar Jardines de Arroyo4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1891229092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "MAUNABO",
            "state": "PR",
            "postal_code": "007070097",
            "telephone_number": "787-861-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR PR3 KM 85.6 BO BUENA VISTA",
            "address_2": "EDIFICIO PLAZ DEL MAR LOCAL 12",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-656-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO TRIXYMAR, PLAZA DEL MAR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIXYMAR INC",
        "enumeration_date": "2017-04-13",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "DIAZ-VEGA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "ADMINISTRADOR",
        "authorized_official_telephone_number": "787-861-1111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.