NPIMap

Organization Active NPI

Atlantis Health Care Group Puerto Rico, Inc.

Doing business as Renal Centre of Manati

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Manati, PR
National Provider Identifier
1922439561
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
#19 Issued in PR
Legal business name
ATLANTIS HEALTH CARE GROUP PUERTO RICO, INC.
Doing business as
Renal Centre of Manati
Practice address
Carr. #2 KM 47.7
Sector Cotto Sur
Manati, PR 00674-7102
Phone
(787) 292-7979
Fax
(787) 292-7999
NPI assigned
Dec 9, 2013
Last updated
Dec 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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 #19 PR Primary

Addresses

Primary practice location

Carr. #2 KM 47.7
Sector Cotto Sur
Manati, PR 00674-7102

Mailing address

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

Other names 1

  • Renal Centre of Manati Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041213000216 PR Part A Provider - End-Stage Renal Disease Facility (ESRD) 1951213172 1 other NPI on this enrollment
Practice locations: Manati, 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": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1922439561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1350",
            "address_2": "ST. JUST STATION",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009771350",
            "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": "CARR. #2 KM 47.7",
            "address_2": "SECTOR COTTO SUR",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006747102",
            "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": "2013-12-09",
        "last_updated": "2013-12-09",
        "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": "#19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Centre of Manati",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.