Individual provider Active NPI

Henry Agustin Lopez, O.D.

  • Optometrist
  • Nashua, NH
National Provider Identifier
1003811191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0544 Issued in NH
Practice address
5 Coliseum Ave
Nashua, NH 03063-3292
Phone
(603) 882-9800
Fax
(603) 882-0556
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0544 NH Primary

Addresses

Primary practice location

5 Coliseum Ave
Nashua, NH 03063-3292

Mailing address

380 D. W. Hwy
Merrimack, NH 03054-4169
Phone (603) 424-6500

Other identifiers 1

IdentifierTypeStateIssuer
30010494MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051022000284 NH Practitioner - Optometry 8224054812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Dr Anthony Fusco
6 March Ave.
Manchester, NH 03103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0544NHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Run Eye Care, P.L.L.C. Optometrist PastSince Apr 13, 2025 Accepting new patients
Dr. Anthony Fusco & Associates Optometrist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003811191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 D. W. HWY",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030544169",
            "telephone_number": "603-424-6500",
            "fax_number": "603-423-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COLISEUM AVE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633292",
            "telephone_number": "603-882-9800",
            "fax_number": "603-882-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "HENRY",
        "middle_name": "AGUSTIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30010494",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.