NPIMap

Organization Active NPI

Integrate Community Health System

Doing business as Metro Pavia Clinic Guayama

  • Clinical Medical Laboratory
  • Guayama, PR
National Provider Identifier
1457710782
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INTEGRATE COMMUNITY HEALTH SYSTEM
Doing business as
Metro Pavia Clinic Guayama
Practice address
Carr 54 KM 03 Ave Principal
Brisas del Mar
Guayama, PR 00784
Phone
(787) 772-9850
Fax
(787) 274-8895
NPI assigned
Feb 15, 2016
Last updated
Jun 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Authorized official

Name
Mrs. Vivian Solivan
Title
President
Phone
(787) 234-8865

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

Carr 54 KM 03 Ave Principal
Brisas del Mar
Guayama, PR 00784

Mailing address

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

Other names 1

  • Metro Pavia Clinic Guayama Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160531000139 PR Part B Supplier - Independent Clinical Laboratory 6507760469 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aguadilla, PR; Bayamon, PR; Guayama, PR; San Juan, PR

Other NPIs on the same Medicare enrollment 3

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

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

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1457710782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CALLE CALAF PMB 455",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-772-9850",
            "fax_number": "787-274-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 54 KM 03 AVE PRINCIPAL",
            "address_2": "BRISAS DEL MAR",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-772-9850",
            "fax_number": "787-274-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATE COMMUNITY HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "SOLIVAN",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-234-8865",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Pavia Clinic Guayama",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guayama, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.