Elite Nephrology Care Center PSC

Organization Active NPI Nephrology Physician · Mayaguez, PR

NPI 1962978262 · NPPES record last updated Oct 15, 2018

Key facts

NPI
1962978262
Entity type
Organization (NPI type 2)
Primary specialty
Nephrology Physician 207RN0300X
Legal business name
ELITE NEPHROLOGY CARE CENTER PSC
Practice address
Edificio Medical Emporium Oficina 203
Carretera 2 KM 156.5 Barrio Sabalos
Mayaguez, PR 00680
Phone
(787) 255-9890
Fax
(787) 255-9891
NPI assigned
Oct 15, 2018
Organization subpart
No

Authorized official

Name
Dr. Pedro Pagan Torres, MD NPI 1013134709
Title
President
Phone
(787) 643-5076

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 4

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210414002036 PR Part B Supplier - Clinic/Group Practice 3072921915 Receives reassigned benefits from 1 practitioner
Practice locations: San German, PR; Mayaguez, PR

National Provider Directory

Locations

357 Ave Hostos
Ofc Park
Mayaguez, PR 00680
Phone (787) 806-2200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RN0300X Yes

Addresses

Primary practice location

Edificio Medical Emporium Oficina 203
Carretera 2 KM 156.5 Barrio Sabalos
Mayaguez, PR 00680

Mailing address

PO Box 203
Cabo Rojo, PR 00623-0203
Phone (787) 643-5076

Other practice location 1

Hospital De La Concepcion
Torre Medica San Vicente De Paul suite 402
San German, PR 00683
Phone (787) 630-2353

Other providers in Mayaguez, PR

All providers in Mayaguez, PR · Nephrology Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.