NPIMap

Organization Active NPI

Saint Lukes Memorial Hospital Inc

Doing business as Clinica SRVS. Psicologico San Lucas

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1962219683
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SAINT LUKES MEMORIAL HOSPITAL INC
Doing business as
Clinica SRVS. Psicologico San Lucas
Practice address
Parking Centro Medico Local 9, 2DO Piso - Plaza Central
San Juan, PR 00935-0001
Phone
(787) 492-2020
Fax
(939) 229-1017
NPI assigned
Dec 16, 2024
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Carlos M Valentin
Title
Finance Director
Phone
(787) 754-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

Parking Centro Medico Local 9, 2DO Piso - Plaza Central
San Juan, PR 00935-0001

Mailing address

PO Box 336810
Ponce, PR 00733-6810
Phone (787) 492-2020

Other names 1

  • CLINICA SRVS. PSICOLOGICO SAN LUCAS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051007000794 PR Part B Supplier - Clinic/Group Practice 1456376599 Receives reassigned benefits from 30 practitioners
3 other NPIs on this enrollment
Practice locations: Ponce, PR; San Juan, PR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Grupo Medico San Lucas7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

Parking Centro Medico
San Juan, PR 00935
Phone (787) 492-2020

Parking Centro Medico Local 9 2do Piso Plz Central
San Juan, PR 00935
Phone (787) 492-2020

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1962219683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336810",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007336810",
            "telephone_number": "787-492-2020",
            "fax_number": "939-229-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PARKING CENTRO MEDICO LOCAL 9, 2DO PISO - PLAZA CENTRAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-492-2020",
            "fax_number": "939-229-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LUKES MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "VALENTIN",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "787-754-8500"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA SRVS. PSICOLOGICO SAN LUCAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.