Hospicio Divina Misericordia Corp.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HOSPICIO DIVINA MISERICORDIA CORP.

Practice address

41 Calle Munoz Rivera
Vega Alta, PR 00692-6533

Phone

(787) 327-0523

NPI assigned

Jun 24, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Wanda E. Moreno

Title

Executive Director

Phone

(787) 516-3107

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Hospice certification: CCN 401572

Legal name

HOSPICIO DIVINA MISERICORDIA, CORP.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 20, 2016

Last certification

Mar 24, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Aug 25, 2009 in PR

Enrollment address

41 Munoz Rivera Avenue
Vega Alta, PR 00692-6533

Listed as

Hospicio Divina Misericordia CorpCCN 401572

Ownership

For-Profit

Certified

Jun 20, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Guillermo Jose Colon, MD

  • General Practice Physician
  • San Juan, PR
  • NPI 1447873872

  W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1932462991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 CALLE MUNOZ RIVERA",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006926533",
            "telephone_number": "787-327-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CALLE MUNOZ RIVERA",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006926533",
            "telephone_number": "787-327-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICIO DIVINA MISERICORDIA CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-24",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-516-3107",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Vega Alta, PR
• Providers in Vega Alta, PR by specialty
• Community Based Hospice Care Agency in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.