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PREMIUM HEALTH GROUP CLINIC
NPI 1306071451
Clinic/Center - Health Service in Carolina, PR

Active since May 19, 2009
LAGUNA GARDENS SHOPPING CENTER, SUITE 101A, CAROLINA, PR 00979(787) 253-1101(787) 791-6273 Get Directions Write a Review

NPPES record last updated: October 20, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 20, 2020, May 7, 2020, Sep 7, 2018 (3 updates tracked since 2018).

About Premium Health Group Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIUM HEALTH GROUP CLINIC (NPI 1306071451) is a healthcare organization registered as a health service in Carolina, Puerto Rico and active in the NPI registry since May 2009. The organization lists Alex Carrasquillo, Administrator, as its authorized official.

NPPES Registry Identity

NPI1306071451
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NamePREMIUM HEALTH GROUP CLINIC
Location AddressLAGUNA GARDENS SHOPPING CENTER, SUITE 101ACarolina, PR 00979
Mailing AddressLaguna Gardens Shopping Center, Suite 101-aCarolina, PR 00979 · (787) 253-1101 · Fax (787) 791-6273
Phone(787) 253-1101
Fax(787) 791-6273
Organization SubpartNo
Authorized OfficialAlex CarrasquilloAdministrator · (787) 253-1101
Enumeration DateMay 19, 2009
Last NPPES UpdateOctober 20, 20203 updates tracked since enumeration
NPPES CertifiedOctober 20, 2020
✔ NPI 1306071451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
Also ListedClinic/Center · RadiologyTaxonomy 261QR0200X

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premium Health Group Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Premium Health Group Clinic, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (6)

Jeannine Badillo Rivera, MD
Diagnostic Radiology
NPI 1649376997
BO JAUCA 11 PLAZA OASIS CARR 153 KM 6-9
Santa Isabel, PR 00757
(787) 263-0644
✔ PECOS✔ Accepts Medicare
Laisha Baez Negron, MD
Rheumatology
NPI 1336660448
LAGUNA GARDENS SHOPPING CENTER SUITE 101A
Carolina, PR 00979
(787) 980-6369
✔ PECOS✔ Accepts Medicare
Benjamin Betancourt, M.D.
Cardiovascular Disease (Cardiology)
NPI 1710977624
FERNADEZ JUNCOS AVE. 1501 SUITE 401 BETANCOURT BUILDING
Santurce, PR 00910
(787) 728-7240
✔ PECOS✔ Accepts Medicare
Kaira Carrasquillo Carasquillo, M.D.
General Practice
NPI 1124332622
CARRETERA 857 KM 9.2 BO CARRUZO
Carolina, PR 00729
(787) 231-1220
✔ PECOS
Carlos Nassar, MD
Diagnostic Radiology
NPI 1922002559
63 CRUZ ORTIZ STELLA AVE.
Humacao, PR 00791
(787) 852-0920
✔ PECOS✔ Accepts Medicare
Jose Nassar, MD
Diagnostic Radiology
NPI 1689678229
63 CRUZ ORTIZ STELLA AVE.
Humacao, PR 00791
(787) 852-0920
✔ PECOS✔ Accepts Medicare

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premium Health Group Clinic's NPI number?

The NPI number for Premium Health Group Clinic is 1306071451. It was assigned to this organization in the NPPES registry on May 19, 2009.

Where is Premium Health Group Clinic located?

Premium Health Group Clinic is located at Laguna Gardens Shopping Center Suite 101A, Carolina, PR 00979. The listed phone number is (787) 253-1101.

What is Premium Health Group Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Is Premium Health Group Clinic enrolled in Medicare?

Yes. Premium Health Group Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premium Health Group Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 4 Medicare specialties reassign their Medicare billing to Premium Health Group Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (3), Cardiovascular Disease (Cardiology) (1) and General Practice (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Premium Health Group Clinic was last updated on October 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.