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INTERNAL COUNCIL MEDICINE ENHANCE PSC NPI 1609073063


NPI Information

NPI: 1609073063
Provider Name: INTERNAL COUNCIL MEDICINE ENHANCE, PSC
Classification: Program of All-Inclusive Care for the Elderly (PACE) Provider Organization - 251T00000X
Entity Type: Organization
Address:
140 JOSE DE DIEGO
ARENAS EXIT
CIDRA, PR
ZIP 00739
Phone: (787) 739-9495
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INTERNAL COUNCIL MEDICINE ENHANCE, PSC is a program of all inclusive care for the elderly pace provider organization in Cidra, PR. The provider is a PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. INTERNAL COUNCIL MEDICINE ENHANCE, PSC NPI is 1609073063. The provider is registered as an organization entity type.

The provider's business location address is:

140 JOSE DE DIEGO
ARENAS EXIT
CIDRA, PR
ZIP 00739-838
Phone: (787) 739-9495
Fax: (787) 296-9767

The provider's authorized official is Sherry Lee Woolard .
The authorized official title is Lawyer and has the following contact phone number (787) 296-9767.

The enumeration date for this NPI number is 6/29/2007 and was last updated on 10/8/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251T00000XProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization207R00000XPUERTO RICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10083318MEDICARE ID-TYPE UNSPECIFIEDPUERTO RICOMEDICARE
2=========OTHERPUERTO RICOFEDERAL TAX ID
3F56477MEDICARE UPINPUERTO RICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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