NPIMap

Organization Active NPI

Integrate Community Health System

Doing business as Metro Pavia Clinic Bayamon

  • Emergency Care Clinic/Center
  • Bayamon, PR
National Provider Identifier
1316169873
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
INTEGRATE COMMUNITY HEALTH SYSTEM
Doing business as
Metro Pavia Clinic Bayamon
Practice address
Urb. Santa Cruz Calle Garcia 849
Bayamon, PR 00956
Phone
(787) 772-9850
Fax
(787) 641-4240
NPI assigned
May 3, 2007
Last updated
Jun 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Authorized official

Name
Vivian Solivan
Title
Director
Phone
(787) 641-4234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X NU Primary

Addresses

Primary practice location

Urb. Santa Cruz Calle Garcia 849
Bayamon, PR 00956

Mailing address

400 Calle Calaf Street PMB 455
San Juan, PR 00918-1314
Phone (787) 772-9850

Other identifiers 2

IdentifierTypeStateIssuer
77OtherPRLICENCIA OPERAR CDT
1025OtherPRLIC. LABORATORIO CLINICO

Other names 1

  • Metro Pavia Clinic Bayamon 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

Locations

9 Calle Garcia
Bayamon, PR 00961

Practitioners & affiliated clinicians

Practitioners 6

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1316169873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CALLE CALAF STREET PMB 455",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181314",
            "telephone_number": "787-772-9850",
            "fax_number": "787-641-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. SANTA CRUZ CALLE GARCIA 849",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-772-9850",
            "fax_number": "787-641-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATE COMMUNITY HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "SOLIVAN",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-641-4234"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA OPERAR CDT",
            "identifier": "77",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC. LABORATORIO CLINICO",
            "identifier": "1025",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Pavia Clinic Bayamon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.