NPIMap

Organization Active NPI

Centro de Imagen

  • Radiology Clinic/Center
  • Vega Alta, PR
National Provider Identifier
1982913646
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
62 Issued in PR
Legal business name
CENTRO DE IMAGEN
Practice address
Carr # 2 KM. 31.9
Bo Bajura
Vega Alta, PR 00692
Phone
(787) 270-3330
Fax
(787) 270-3335
NPI assigned
Sep 29, 2010
Organization subpart
Yes
Parent organization
VEGA ALTA COMMUNITY HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Authorized official

Name
Dr. Luis M Gonzalez, MD
Title
President
Phone
(787) 270-3330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 62 PR Primary

Addresses

Primary practice location

Carr # 2 KM. 31.9
Bo Bajura
Vega Alta, PR 00692

Mailing address

PO Box 419
Vega Alta, PR 00692-0419
Phone (787) 270-3330

Other names 1

  • Vega Alta Community Health, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061121000129 PR Part B Supplier - Clinic/Group Practice 1759389026 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vega Alta, 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
Vega Alta Community Health2 organizations share this tax ID, including this one
Part of
Vega Alta Community Health

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1982913646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006920419",
            "telephone_number": "787-270-3330",
            "fax_number": "787-270-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR # 2 KM. 31.9",
            "address_2": "BO BAJURA",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "00692",
            "telephone_number": "787-270-3330",
            "fax_number": "787-270-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE IMAGEN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VEGA ALTA COMMUNITY HEALTH, INC.",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-270-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "PR",
            "license": "62",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vega Alta Community Health, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Vega Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.