NPIMap

Organization Active NPI

Puerto Rico Primary Care, Mso, Inc. - Laboratorio

  • Clinical Medical Laboratory
  • Luquillo, PR
National Provider Identifier
1952055055
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PUERTO RICO PRIMARY CARE, MSO, INC. - LABORATORIO
Practice address
Calle 14 de Julio No 159
Bo Mata de Platano
Luquillo, PR 00773
Phone
(787) 885-4446
Fax
(787) 885-6129
NPI assigned
Feb 8, 2022
Last updated
Feb 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PUERTO RICO PRIMARY CARE MSO, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Keila Centeno
Title
Administrator
Phone
(787) 534-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

Calle 14 de Julio No 159
Bo Mata de Platano
Luquillo, PR 00773

Mailing address

PO Box 818
Ceiba, PR 00735-0818
Phone (787) 534-3789

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230925002483 PR Part B Supplier - Clinic/Group Practice 3274987268 Receives reassigned benefits from 19 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Luquillo, PR

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Puerto Rico Primary Care Mso Inc - CDT Luquillo4 organizations share this tax ID, including this one
Part of
Puerto Rico Primary Care Mso Inc - CDT Luquillo

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1952055055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "CEIBA",
            "state": "PR",
            "postal_code": "007350818",
            "telephone_number": "787-534-3789",
            "fax_number": "787-885-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 14 DE JULIO NO 159",
            "address_2": "BO MATA DE PLATANO",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "00773",
            "telephone_number": "787-885-4446",
            "fax_number": "787-885-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUERTO RICO PRIMARY CARE, MSO, INC. - LABORATORIO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUERTO RICO PRIMARY CARE MSO, INC",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "CENTENO",
        "authorized_official_first_name": "KEILA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-534-3789"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luquillo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.