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MIGRANT HEALTH CENTER WESTERN REGION,INC
Complete NPI Record 1609969286
Clinic/Center - Federally Qualified Health Center (FQHC) in Mayaguez, PR

NPI Status: Active since October 02, 2006

Contact Information

CALLE RAMON EMETERIO BETANCES 497
COND BLDG
MAYAGUEZ, PR
ZIP 00680
Phone: (787) 805-2900
Fax: (787) 265-4245

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Second Line Business Practice Location Address
  16. Provider Business Practice Location Address City Name
  17. Provider Business Practice Location Address State Name
  18. Provider Business Practice Location Address Postal Code
  19. Provider Business Practice Location Address Country Code If outside U S
  20. Provider Business Practice Location Address Telephone Number
  21. Provider Business Practice Location Address Fax Number
  22. Provider Enumeration Date
  23. Last Update Date
  24. Authorized Official Last Name
  25. Authorized Official First Name
  26. Authorized Official Middle Name
  27. Authorized Official Title or Position
  28. Authorized Official Telephone Number
  29. Healthcare Provider Taxonomy Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Healthcare Provider Taxonomy Code 2
  32. Healthcare Provider Primary Taxonomy Switch 2
  33. Healthcare Provider Taxonomy Code 3
  34. Healthcare Provider Primary Taxonomy Switch 3
  35. Healthcare Provider Taxonomy Code 4
  36. Healthcare Provider Primary Taxonomy Switch 4
  37. Healthcare Provider Taxonomy Code 5
  38. Healthcare Provider Primary Taxonomy Switch 5
  39. Healthcare Provider Taxonomy Code 6
  40. Healthcare Provider Primary Taxonomy Switch 6
  41. Healthcare Provider Taxonomy Code 7
  42. Healthcare Provider Primary Taxonomy Switch 7
  43. Healthcare Provider Taxonomy Code 8
  44. Healthcare Provider Primary Taxonomy Switch 8
  45. Healthcare Provider Taxonomy Code 9
  46. Provider License Number 9
  47. Provider License Number State Code 9
  48. Healthcare Provider Primary Taxonomy Switch 9
  49. Healthcare Provider Taxonomy Code 10
  50. Healthcare Provider Primary Taxonomy Switch 10
  51. Healthcare Provider Taxonomy Code 11
  52. Healthcare Provider Primary Taxonomy Switch 11
  53. Healthcare Provider Taxonomy Code 12
  54. Healthcare Provider Primary Taxonomy Switch 12
  55. Healthcare Provider Taxonomy Code 13
  56. Healthcare Provider Primary Taxonomy Switch 13
  57. Healthcare Provider Taxonomy Code 14
  58. Healthcare Provider Primary Taxonomy Switch 14
  59. Healthcare Provider Taxonomy Code 15
  60. Healthcare Provider Primary Taxonomy Switch 15
  61. Is Organization Subpart
  62. Authorized Official Name Prefix Text
  63. Healthcare Provider Taxonomy Group 1
  64. Healthcare Provider Taxonomy Group 2
  65. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1609969286. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1609969286
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: UNAVAIL
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 6
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: PO BOX 190
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: MAYAGUEZ
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: PR
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 006810190
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 7878052920
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 7878341924
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: CALLE RAMON EMETERIO BETANCES 497
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: COND BLDG
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MAYAGUEZ
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: PR
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 006801714
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7878052900
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7872654245
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/2/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 3/21/2025
The date that a record was last updated or changed.
Authorized Official Last Name: MORALES
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: TANIA
The first name of the authorized official.
Authorized Official Middle Name: RODRIGUEZ
The middle name of the authorized official.
Authorized Official Title or Position: DIRECTORA EJECUTIVA
The title or position of the authorized official.
Authorized Official Telephone Number: 7878315800
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 225X00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 235Z00000X
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 261QD0000X
Healthcare Provider Primary Taxonomy Switch 3: N
Healthcare Provider Taxonomy Code 4: 261QD1600X
Healthcare Provider Primary Taxonomy Switch 4: N
Healthcare Provider Taxonomy Code 5: 261QF0400X
Healthcare Provider Primary Taxonomy Switch 5: Y
Healthcare Provider Taxonomy Code 6: 261QM0801X
Healthcare Provider Primary Taxonomy Switch 6: N
Healthcare Provider Taxonomy Code 7: 261QM0850X
Healthcare Provider Primary Taxonomy Switch 7: N
Healthcare Provider Taxonomy Code 8: 261QM0855X
Healthcare Provider Primary Taxonomy Switch 8: N
Healthcare Provider Taxonomy Code 9: 261QM1000X
Provider License Number 9: 06148
Provider License Number State Code 9: PR
Healthcare Provider Primary Taxonomy Switch 9: N
Healthcare Provider Taxonomy Code 10: 261QM1300X
Healthcare Provider Primary Taxonomy Switch 10: N
Healthcare Provider Taxonomy Code 11: 261QR0200X
Healthcare Provider Primary Taxonomy Switch 11: N
Healthcare Provider Taxonomy Code 12: 261QR0206X
Healthcare Provider Primary Taxonomy Switch 12: N
Healthcare Provider Taxonomy Code 13: 261QR0207X
Healthcare Provider Primary Taxonomy Switch 13: N
Healthcare Provider Taxonomy Code 14: 291U00000X
Healthcare Provider Primary Taxonomy Switch 14: N
Healthcare Provider Taxonomy Code 15: 3336C0003X
Healthcare Provider Primary Taxonomy Switch 15: N
Is Organization Subpart: N
Authorized Official Name Prefix Text: DR.
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 3/20/2025