Nilsa Ivette Sanchez Shumate/Laboratorio Clinico Modelo

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

523 Issued in PR

Legal business name

NILSA IVETTE SANCHEZ SHUMATE/LABORATORIO CLINICO MODELO

Doing business as

Laboratorio Clinico Modelo

Practice address

170 Ave Barbosa
Catano, PR 00962

Phone

(787) 788-1428

Fax

(787) 788-2409

NPI assigned

Dec 30, 2005

Last updated

Sep 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nilsa I Sanchez Shumate, BA

Title

Owner

Phone

(787) 788-1428

Specialties & licenses 1

Addresses

Other identifiers 12

Other names 1

• Laboratorio Clinico Modelo Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1932186855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 598",
            "city": "CATANO",
            "state": "PR",
            "postal_code": "009630598",
            "telephone_number": "787-788-1428",
            "fax_number": "787-788-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 AVE BARBOSA",
            "city": "CATANO",
            "state": "PR",
            "postal_code": "00962",
            "telephone_number": "787-788-1428",
            "fax_number": "787-788-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NILSA IVETTE SANCHEZ SHUMATE/LABORATORIO CLINICO MODELO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-09-13",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ SHUMATE",
        "authorized_official_first_name": "NILSA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-788-1428",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL MEDICAL CAR",
            "identifier": "0794",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH MEDICARE",
            "identifier": "1000",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH",
            "identifier": "20200",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3-0315",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH",
            "identifier": "400646",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLOBAL HEALTH PLAN",
            "identifier": "011-523",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICARE CHOICE",
            "identifier": "20141",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "800047",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "962-0064",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS, OPTIMO, SELECTO",
            "identifier": "3-0315",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APS",
            "identifier": "1349",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALIC",
            "identifier": "LA-0244",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Modelo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Municipality of Catano
• Municipality of Catano (Radiologia CDT Eulalia Kuilan)
• Municipality of Catano
• Municipio de Catano (CDT Eulalia Kuilan - Sala de Emergencia)
• Karla Nerushka Negron, RRNA
• Ortho Elite Group LLC
• Mercedes Del Carmen Ortiz Vega, MTS
• Jose Ramon Ortiz
• Mabel Osorio Castro
• Ruth Mileidy Pagan Custodio

• Clinical Medical Laboratory in Catano, PR
• Providers in Catano, PR by specialty
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.