NPIMap

Organization Active NPI

Corredor Azul Integral LLC

  • Multi-Specialty Clinic/Center
  • Bayamon, PR
National Provider Identifier
1346097672
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CORREDOR AZUL INTEGRAL LLC
Practice address
River Town Plaza
50 Ave Los Filtros, Bo. Juan Sanchez
Bayamon, PR 00969
Phone
(787) 378-9001
NPI assigned
May 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Bernice Lopez
Title
Administrator
Phone
(787) 378-9001

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Obesity and Weight Management Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1201X
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Diabetes Educator Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WD0400X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Obesity Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083B0002X
Multi-Specialty Clinic/Center 261QM1300X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

River Town Plaza
50 Ave Los Filtros, Bo. Juan Sanchez
Bayamon, PR 00969

Mailing address

105 Carr. 21 Bo. Monacillos,
Suite 206
San Juan, PR 00927
Phone (787) 378-9001

Other names 1

  • A1 Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250220000372 PR Part B Supplier - Clinic/Group Practice 0749700888 Receives reassigned benefits from 9 practitioners
Practice locations: Bayamon, PR

National Provider Directory

National Provider Directory
Tax ID family
A1 Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

50 Ave Los Filtros
Bayamon, PR 00959
Phone (787) 378-9001

105 Carr 21
Ste 206
San Juan, PR 00927

Practitioners & affiliated clinicians

Practitioners 9

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": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1346097672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CARR. 21 BO. MONACILLOS,",
            "address_2": "SUITE 206",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-378-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIVER TOWN PLAZA",
            "address_2": "50 AVE LOS FILTROS, BO. JUAN SANCHEZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-378-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORREDOR AZUL INTEGRAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-03",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-378-9001"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A1 Clinic",
            "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 Mar 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.