Organization Active NPI

Solidarity Medical Group, Inc.

  • Health Maintenance Organization
  • Mayaguez, PR
National Provider Identifier
1962670661
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
SOLIDARITY MEDICAL GROUP, INC.
Practice address
11-A
Calle Santo Tomas
Mayaguez, PR 00680
Phone
(787) 834-6056
NPI assigned
Feb 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Marcos A. Ayala
Title
Presidente
Phone
(787) 834-6056

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

11-A
Calle Santo Tomas
Mayaguez, PR 00680

Mailing address

101 Calle Mendez Vigo W Ste 701
Mayaguez, PR 00680-3889
Phone (787) 215-6056

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220805001547 PR Part B Supplier - Clinic/Group Practice 7113309287 Receives reassigned benefits from 1 practitioner
Practice locations: Mayaguez, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1962670661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CALLE MENDEZ VIGO W STE 701",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006803889",
            "telephone_number": "787-215-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11-A",
            "address_2": "CALLE SANTO TOMAS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-834-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLIDARITY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-834-6056"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.