Organization Active NPI

Condado Wellness Center PSC

  • Multi-Specialty Clinic/Center
  • San Juan, PR
National Provider Identifier
1013482066
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CONDADO WELLNESS CENTER PSC
Practice address
150 Calle de Diego
San Juan, PR 00925-3406
Phone
(787) 230-7557
NPI assigned
Oct 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Alfredo Ayala
Title
President
Phone
(787) 230-7557

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
ReflexologistGroup: 193200000X MULTI-SPECIALTY GROUP 173C00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

150 Calle de Diego
San Juan, PR 00925-3406

Mailing address

100 Paseo San Pablo Ste 503
Bayamon, PR 00961-7028
Phone (787) 230-7557

Other identifiers 1

IdentifierTypeStateIssuer
039053800MedicaidPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220825000125 PR Part B Supplier - Clinic/Group Practice 4284018201 Receives reassigned benefits from 2 practitioners
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

100 Paseo San Pablo
Ste 503
Bayamon, PR 00961
Phone (787) 798-0100

150 Calle de Diego
San Juan, PR 00925
Phone (787) 230-7557

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1013482066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PASEO SAN PABLO STE 503",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617028",
            "telephone_number": "787-230-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CALLE DE DIEGO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009253406",
            "telephone_number": "787-230-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONDADO WELLNESS CENTER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-05",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-230-7557",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039053800",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.