Providers

PHYSICIAN H.M.O. INC.

NPI 1730481649, organization, San Juan, PR, Emergency Medical Technician, Intermediate

1
Evidence tier
adjudicated in a public enforcement record
  • Adjudicated (pleaded guilty) per a Department of Justice release dated July 17, 2025.
  • Medicaid paid $81,097 in the last 12 observed months.
score 95 of 100, rank 158, $81K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NamePHYSICIAN H.M.O. INC. (also PHYSIAN H.M.O. INC.)
TypeOrganization
StatusActive
NPI issuedNovember 29, 2010, last updated February 23, 2016
Practice locationCALLE PADRE DE LAS CASA, #107, San Juan, PR 00918, 787-294-7801
Mailing addressP.O. BOX 193044, San Juan, PR 00919-3044
Authorized officialRAUL VILLALOBOS DIAZ (Presidente)
Specialties
Emergency Medical Technician, Intermediate (146M00000X, primary)

In this area

12 providers in San Juan Municipio County, PR carry an indicator in the public record, with $5.1M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by named in an enforcement record on 2. 2 are tier 1: documented action, then payment.

tierproviderat stakewhy
1PHYSICIAN HMO INC.
San Juan, PR, ranked 408
$680
  • Adjudicated (pleaded guilty) per a Department of Justice release dated July 17, 2025.
  • Medicaid paid $680 in the last 12 observed months.
1PHYSICIAN HMO INC.
Rio Piedras, PR, ranked 460
$0
  • Adjudicated (pleaded guilty) per a Department of Justice release dated July 17, 2025.
  • No Medicaid payments in the last 12 observed months.
3CMS HOME CARE METRO, LLC.
San Juan, PR, ranked 5251
$0
  • Part of provider network D1-00068, ranked 68 nationally.
4FRANKIE ALVARADO
San Juan, PR, ranked 7831
$1.0M
  • Hours beyond a day in 3 months under one organization, which can be supervisory billing.
  • Records needed.
  • and 1 more
4JAN RODRIGUEZ FERRER
San Juan, PR, ranked 7946
$483K
  • Hours beyond a day in 2 months under one organization, which can be supervisory billing.
  • Records needed.
  • and 1 more
4ARNALDO CRUZ IGARTUA
San Juan, PR, ranked 8890
$1.3M
  • Hours beyond a day in 1 month, but with up to 683 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4WALESKA LIND
San Juan, PR, ranked 9521
$144K
  • Hours beyond a day in 2 months, but with up to 224 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5UBALDO SANTIAGO BUONO
San Juan, PR, ranked 10108
$996K
  • Medicaid dollars per patient on code 99233 ($251 per patient-month) sit in the top 5% of every provider billing that code.
All 12 in PR

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.

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