Organization Active NPI

Mennonite General Hospital, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Guayama, PR
National Provider Identifier
1952967564
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MENNONITE GENERAL HOSPITAL, INC
Practice address
Avenida Pedro Albizu Campos
Avenida Pedro Albizu Campos Bo. Machetes
Guayama, PR 00784-0011
Phone
(787) 437-1700
Fax
(787) 434-1715
NPI assigned
May 20, 2019
Organization subpart
Yes
Parent organization
CENTRO DE SALUD CONDUCTUAL MENONITA CIMAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Lissette Vasquez Rivera
Title
Director of Billing and Collection
Phone
(787) 434-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

Avenida Pedro Albizu Campos
Avenida Pedro Albizu Campos Bo. Machetes
Guayama, PR 00784-0011

Mailing address

PO Box 1650
Cidra, PR 00739-1650
Phone (787) 434-1700

Other identifiers 1

IdentifierTypeStateIssuer
6OtherPRLICENCE OF HEALTH DEPARTMENT

Other names 1

  • Centro de Salud Conductual Menonita ambulatorio Guayama Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lvazquez@mghpr.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041220000467 PR Part B Supplier - Clinic/Group Practice 6709843964 Receives reassigned benefits from 206 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ponce, PR; Orocovis, PR; Caguas, PR; Aibonito, PR; Guayama, PR

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Centro de Salud Conductual Menonita Cima41 organizations share this tax ID, including this one
Part of
Centro de Salud Conductual Menonita Cima

Other organizations with this tax ID 40

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

View all 40

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1952967564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1650",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007391650",
            "telephone_number": "787-434-1700",
            "fax_number": "787-434-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA PEDRO ALBIZU CAMPOS",
            "address_2": "AVENIDA PEDRO ALBIZU CAMPOS BO. MACHETES",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007840011",
            "telephone_number": "787-437-1700",
            "fax_number": "787-434-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENNONITE GENERAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRO DE SALUD CONDUCTUAL MENONITA CIMA",
        "enumeration_date": "2019-05-20",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ RIVERA",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING AND COLLECTION",
        "authorized_official_telephone_number": "787-434-1700"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE OF HEALTH DEPARTMENT",
            "identifier": "6",
            "state": "PR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvazquez@mghpr.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fisical",
            "address_1": "La Fuente Town Center",
            "address_2": "Ave. Pedro albizu Campos Marginal Suite 109",
            "city": "Guayama",
            "state": "PR",
            "country_code": "US",
            "postal_code": "007840011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Centro de Salud Conductual Menonita ambulatorio Guayama",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centro de Salud Conductual Menonita ambulatorio Guayama",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guayama, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.