NPIMap

Organization Active NPI

Integrate Community Health System

Doing business as Metro Pavia Clinic Fajardo

  • Internal Medicine Physician
  • Fajardo, PR
National Provider Identifier
1235756339
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTEGRATE COMMUNITY HEALTH SYSTEM
Doing business as
Metro Pavia Clinic Fajardo
Practice address
Carr # 3, KM 43.8
Bo. Quebrada Fajardo
Fajardo, PR 00738
Phone
(787) 710-9867
NPI assigned
Jul 6, 2020
Last updated
Jan 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Maria Lopez
Title
VP Senior
Phone
(787) 230-7530

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

Carr # 3, KM 43.8
Bo. Quebrada Fajardo
Fajardo, PR 00738

Mailing address

400 Calle Calaf PMB 455
San Jaun, PR 00918-1314
Phone (787) 370-6648

Other names 1

  • Metro Pavia Clinic Fajardo Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000113 PR Part B Supplier - Clinic/Group Practice 6507760469 Receives reassigned benefits from 52 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Caguas, PR; San Juan, PR; Luquillo, PR; Humacao, PR; Guayama, PR; Fajardo, PR; Carolina, PR; Bayamon, PR…

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Integrate Community Health System34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1235756339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CALLE CALAF PMB 455",
            "city": "SAN JAUN",
            "state": "PR",
            "postal_code": "009181314",
            "telephone_number": "787-370-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR # 3, KM 43.8",
            "address_2": "BO. QUEBRADA FAJARDO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-710-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATE COMMUNITY HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "VP SENIOR",
        "authorized_official_telephone_number": "787-230-7530"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Pavia Clinic Fajardo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Metro Pavia Clinic Fajardo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.