NPIMap

Organization Active NPI

Fajardo Integrated Medical Center

  • General Acute Care Hospital
  • Fajardo, PR
National Provider Identifier
1962280131
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
FAJARDO INTEGRATED MEDICAL CENTER
Practice address
404 Ave General Valero
Fajardo, PR 00738-3998
Phone
(787) 801-0081
NPI assigned
Sep 19, 2023
Last updated
Jun 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Sara LopezNPI 1003931726
Title
Ceo
Phone
(787) 801-0081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

404 Ave General Valero
Fajardo, PR 00738-3998

Mailing address

PO Box 70006
Fajardo, PR 00738-7006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240621000415 PR Part A Provider - Hospital 7315480100 Practice locations: Fajardo, PR
O20241002003671 PR Part B Supplier - Clinic/Group Practice 7315480100 Receives reassigned benefits from 26 practitioners
Practice locations: Fajardo, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962280131. Details of each certification follow.

Hospital certification: CCN 400141

Legal name
FAJARDO INTEGRATED MEDICAL CENTER
Doing business as
CENTRO MEDICO DEL NORESTE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 7, 2025
Last certification
Jul 17, 2025
Beds
87 (54 certified)
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
404 Ave General Valero
Fajardo, PR 7383998
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Centro Medico del NoresteCCN 400141 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Caribe Physicians Plaza Corporation Organization, Fajardo, PR Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 25, 2023 33.28%
Sara Lopez Martin Individual 5% Or Greater Indirect Ownership InterestCeo Oct 25, 2023 31.13%
Carlos Fontanez Reyes Individual 5% Or Greater Indirect Ownership Interest Oct 25, 2023 7.68%
Fidel C de Frias Jimenez Individual 5% Or Greater Indirect Ownership Interest Oct 25, 2023 20.48%
Luis Torres Individual W-2 Managing EmployeeChief Financial Officer Apr 24, 2024

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

Affiliated clinicians 28

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1962280131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70006",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007387006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 AVE GENERAL VALERO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383998",
            "telephone_number": "787-801-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAJARDO INTEGRATED MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-801-0081"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

Verify at the official NPI Registry.