(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. |
Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
NPI |
Name |
Taxonomy |
Address |
Enumeration |
1255696340 |
Prosto-dental, Psc
|
Exclusive Provider Organization
|
Rio Amazonas Valle Verde, Bc20, Bayamon, PR 00961 |
2012-07-05 |
1912192642 |
Dr Wilmer Valentin Gonzalez, Psc
|
Exclusive Provider Organization
|
Street No 2 No 46, Professional Hospital, Bayamon, PR 00960 |
2007-09-06 |
1447324264 |
Millennium Medical
|
Exclusive Provider Organization
|
Santa Cruz Street, # 20, Bayamon, PR 00961-6900 |
2006-11-20 |
1114322914 |
Applied Psychology and Research, Inc.
|
Exclusive Provider Organization
|
11-16 Carr 174, Bayamon, PR 00959-6609 |
2014-10-23 |
1770731259 |
Sonrisas Hermosas, Csp
|
Exclusive Provider Organization
|
Calle Marginal, Road 1 Km. 16.1, Bayamon, PR 00957-2536 |
2008-09-08 |
1336214485 |
Metro Medical Health Group, Inc.
|
Exclusive Provider Organization
|
Santa Cruz Street, # 20, Bayamon, PR 00960-5598 |
2006-11-22 |
1033284898 |
Millennium Medical Health Group
|
Exclusive Provider Organization
|
Santa Cruz Street, # 20, Bayamon, PR 00961-6900 |
2006-11-21 |
1407921901 |
Opcion Mca Inc.
|
Exclusive Provider Organization
|
Santa Cruz Street, # 20, Bayamon, PR 00961-6900 |
2006-11-21 |
NPI |
Name |
Taxonomy |
Address |
Enumeration |
1427667906 |
Northwestern Renal Care Psc
|
Exclusive Provider Organization
|
Edificio Western Plaza, Oficina 10, Ave. Severiano Cuevas 18, Carr 460 Km 1.2 Int, Aguadilla, PR 00603 |
2020-07-30 |
1295247211 |
3 Plus Management
|
Exclusive Provider Organization
|
Centro Internacional De Mercadeo Torre II, Suite 402, Guaynabo, PR 00968 |
2017-10-31 |
1942743208 |
Farmacia La Candelaria Inc.
|
Exclusive Provider Organization
|
Ave 111 Km 18.7, San Sebastian, PR 00667 |
2016-11-18 |
1295282499 |
Functional Endocrinology Institute P.s.c
|
Exclusive Provider Organization
|
120 Calle Carazo, Guaynabo, PR 00970 |
2016-09-06 |
1740653229 |
Kiana Med Serv Inc
|
Exclusive Provider Organization
|
529 Calle W Morales, Urb Estancias Del Golf, Ponce, PR 00730 |
2015-11-05 |
1538559596 |
Aliansa De Salud Primaria Inc.
|
Exclusive Provider Organization
|
#14 Calle Betances, Santa Isabel, PR 00757 |
2015-01-29 |
1922402437 |
A.collazo Md, Csp
|
Exclusive Provider Organization
|
Ave. Ponce By Pass 2225, Suite 409, Ponce, PR 00717-1322 |
2014-10-13 |
1831592120 |
Sociedad De Salud Mental, LLC
|
Exclusive Provider Organization
|
118 Carr 159 Ste 2b, Ortiz Medical Plaza, Corozal, PR 00783-2346 |
2014-10-01 |
1013317734 |
Servicios Medicos Del Plata 4352
|
Exclusive Provider Organization
|
349 Mendez Vigo, Suite 10, Dorado, PR 00646-0687 |
2014-08-29 |
1184039141 |
Centro Obstetrico Y Ginecologico Incorporado
|
Exclusive Provider Organization
|
B9 Ave Los Veteranos, Urb Villa Rosa IIi, Guayama, PR 00784 |
2014-06-27 |
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