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Organization Active NPI

Atlantis Health Care Group Puerto Rico Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Isabela, PR
National Provider Identifier
1922293240
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
LIC #41 CNC 07-179 Issued in PR
Legal business name
ATLANTIS HEALTH CARE GROUP PUERTO RICO INC
Practice address
Carretera #2 KM 113.5
Bo. Guerrero
Isabela, PR 00662-0000
Phone
(787) 292-7979
Fax
(787) 872-8429
NPI assigned
Sep 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 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 LIC #41 CNC 07-179 PR Primary

Addresses

Primary practice location

Carretera #2 KM 113.5
Bo. Guerrero
Isabela, PR 00662-0000

Mailing address

PO Box 1350
Saint Just Station
Trujillo Alto, PR 00977-1350
Phone (787) 292-7979

Other identifiers 1

IdentifierTypeStateIssuer
660675890OtherPRIRS

Other names 1

  • Renal Center of Isabela Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080827000091 PR Part A Provider - End-Stage Renal Disease Facility (ESRD) 1951213172 Practice locations: Isabela, 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

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": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1922293240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1350",
            "address_2": "SAINT JUST STATION",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009771350",
            "telephone_number": "787-292-7979",
            "fax_number": "787-872-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA #2 KM 113.5",
            "address_2": "BO. GUERRERO",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006620000",
            "telephone_number": "787-292-7979",
            "fax_number": "787-872-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIS HEALTH CARE GROUP PUERTO RICO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2014-04-14",
        "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": "LIC #41 CNC 07-179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "660675890",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Center of Isabela",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Isabela, PR

Sources for this page

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