Individual provider Active NPI

Raul A. Lopez Gonzalez, M.D.

  • Surgery Physician
  • Mesa, AZ
National Provider Identifier
1003872318
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
32357 Issued in AZ
Practice address
5555 E Baseline Rd
Mesa, AZ 85206-4709
Phone
(480) 393-0575
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 32357 AZ Primary

Addresses

Primary practice location

5555 E Baseline Rd
Mesa, AZ 85206-4709

Mailing address

5555 E Baseline Rd
Mesa, AZ 85206-4709
Phone (480) 393-0575

Other identifiers 1

IdentifierTypeStateIssuer
871253MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040907001031 AZ Practitioner - General Surgery 7810983103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Gi Associates CurrentSince Jun 10, 2021 Accepting new patients
Reddy Gi Associates Gastroenterology CurrentSince Jun 10, 2021 Accepting new patients
Sun Health Corporation Past Accepting new patients
Central Arizona Gi & Liver Institute LLC Past Accepting new patients
Clinical Associates in Internal Medicine, LTD Past Accepting new patients
Banner Sun City Medical Group Past Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000

604 W Warner Rd
Ste D1
Chandler, AZ 85225
Phone (480) 393-5075

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

4001 E Baseline Rd
Ste 102
Gilbert, AZ 85234
Phone (480) 565-8045

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

4001 E Baseline Rd
#102103
Gilbert, AZ 85234

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

5555 E Baseline Rd
Mesa, AZ 85206
Phone (480) 393-5075

9130 E Elliot Rd
Mesa, AZ 85212
Phone (480) 410-4500

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

6707 N 19th Ave
Ste 200
Phoenix, AZ 85015
Phone (602) 249-4750

37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000

Networks

  • NM HMO C-SNP

Organizations & group practices 6

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1003872318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064709",
            "telephone_number": "480-393-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064709",
            "telephone_number": "480-393-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ GONZALEZ",
        "first_name": "RAUL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "32357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871253",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.