NPIMap

Organization Active NPI

Clinica Yaguez, Inc.

Doing business as Laboratorio Clinico Dr. Basora

  • Clinical Medical Laboratory
  • Mayaguez, PR
National Provider Identifier
1902366651
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CLINICA YAGUEZ, INC.
Doing business as
Laboratorio Clinico Dr. Basora
Practice address
24 Calle Dr Basora N
Mayaguez, PR 00680-4182
Phone
(787) 832-8445
NPI assigned
Mar 20, 2019
Last updated
Apr 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Carlos I Huertas
Title
Finance Director
Phone
(787) 832-8444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

24 Calle Dr Basora N
Mayaguez, PR 00680-4182

Mailing address

PO Box 698
Mayaguez, PR 00681-0698
Phone (787) 832-8445

Other names 1

  • LABORATORIO CLINICO DR. BASORA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051007000046 PR Part B Supplier - Independent Clinical Laboratory 9830175033 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mayaguez, PR

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Clinica Yaguez Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1902366651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810698",
            "telephone_number": "787-832-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CALLE DR BASORA N",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804182",
            "telephone_number": "787-832-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA YAGUEZ, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "HUERTAS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "787-832-8444"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO DR. BASORA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.