Providers

PHYSICIAN HMO INC

NPI 1427320332, organization, Carolina, PR, General Practice

Evidence tier
No indicators
No detector reached this NPI and it appears on none of the loaded lists.

National provider registry

From the CMS NPPES Registry, refreshed daily.

NamePHYSICIAN HMO INC (also CLINICA DRES VILLALOBOS IPA 623)
TypeOrganization
StatusActive
NPI issuedFebruary 8, 2012, last updated October 24, 2012
Practice locationAVE FERNANDEZ JUNCOS ESQUINA MOLINILLOS EDIF JESUS T PI, Carolina, PR 00982, 787-767-8758
Mailing addressPO BOX 193044, San Juan, PR 00919-3044
Authorized officialRAUL VILLALOBOS (President)
Specialties
General Practice (208D00000X, primary)

In this area

3 providers in Carolina, PR carry an indicator in the public record, with $4.0M at stake between them. The most common is more hours than a day holds, on 3 of them.

tierproviderat stakewhy
4MARIA RIVERA CRUZ
Carolina, PR, ranked 8544
$3.1M
  • Hours beyond a day in 4 months, but with up to 521 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4JORGE VAZQUEZ MARCANO
Carolina, PR, ranked 9568
$102K
  • Hours beyond a day in 2 months under one organization, which can be supervisory billing.
  • Records needed.
5JOSE COLON - MARQUEZ
Carolina, PR, ranked 10162
$758K
  • Medicaid dollars per patient on code 99233 ($607 per patient-month) sit in the top 5% of every provider billing that code.

Recent enforcement in PR

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJIndictedJun 23, 2026
2026 National Health Care Fraud Takedown
Four defendants were charged in two schemes, one involving the advertising, sale, and distribution of Semaglutide, Mounjaro, steroids, and Tirzepatide that defendants were not authorized to possess and distribute, and the other involving performing dental procedures on patients without a valid dental license and misbranding of devices.
DOJCivil settlementJun 4, 2026
Puerto Rico Pharmacies Agree to Pay $4.6 Million to Federal Authorities in Medicare and Medicaid Fraud Cases
Four pharmacies and their owners agreed to pay $4.6 million to resolve allegations that between January 2021 and January 2024 they billed Medicare and Medicaid for diverted prescriptions sold to patients that had been misrepresented as properly sourced despite unverifiable origins.
DOJPleaded guiltyJul 17, 2025
Physician Assistant who Pretended to be a Licensed Physician Pleads Guilty to Making False Statements to an Agency of the United States
Villalobos-Meléndez, a licensed physician assistant who was never licensed to practice medicine, forged medical license and USMLE documents, worked as a physician in a hospital internship program, and submitted false license information on a CMS-855I form seeking enrollment as a Medicare physician provider with benefits reassigned to Physician HMO.
DOJCivil settlementDec 23, 2024
MMM Holdings, LLC Agrees to Pay 15.2 Million Dollars to Resolve Allegations that it Violated the False Claims Act and Anti-Kickback Statute
MMM Holdings distributed gift cards to administrative assistants of providers to induce the referral, recommendation, or arrangement for enrollment of thousands of Medicare beneficiaries in an MMM Medicare Advantage plan and submitted or caused claims for payment to Medicare.
DOJIndictedSep 25, 2024
27 Individuals Indicted for Buying and Selling Wholesale Quantities of Misbranded and Diverted Prescription Drugs Resold to the Public Through Retail Pharmacies in Puerto Rico
Defendants engaged in unlicensed wholesale distribution of misbranded and diverted prescription drugs sold to pharmacy owners and employees who resold them to customers and billed health care benefit plans as if the drugs were authentic and obtained through licensed distribution channels.

Referral packet

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