Individual provider Active NPI

Gerardo Lopez Mejia, M.D.

  • Family Medicine Physician
  • Choctaw, OK
National Provider Identifier
1003956624
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25202 Issued in OK
Practice address
14321 NE 23Rd St
Choctaw, OK 73020-8624
Phone
(405) 342-0255
Fax
(405) 610-6960
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25202 OK Primary

Addresses

Primary practice location

14321 NE 23Rd St
Choctaw, OK 73020-8624

Mailing address

14321 NE 23Rd St
Choctaw, OK 73020-8624
Phone (405) 342-0255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20100723000749 OK Practitioner - Family Practice 0547392748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Oklahoma Ambulatory Services LLCGroup PAC ID 9830447036, 43 clinicians

Practice addresses (Care Compare)

1380 W Covell Rd
132 Mercy Gohealth Urgent Care N Edmond
Edmond, OK 73003-3575
Phone (405) 279-9637

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25202OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Oklahoma Ambulatory Services LLC CurrentSince Aug 31, 2018 Accepting new patients
Healthcare Express, LLP Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc PastSince Aug 31, 2018 Accepting new patients

Locations

2300 E 2nd St
Edmond, OK 73034

1380 W Covell Rd
Ste 132
Edmond, OK 73003
Phone (405) 279-9637

12220 N MacArthur Blvd
Ste D
Oklahoma City, OK 73162
Phone (405) 437-1100

1701 S Douglas Blvd
Oklahoma City, OK 73130
Phone (405) 302-8999

3515 Richmond Rd
Texarkana, TX 75503
Phone (903) 831-7270

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBHHAD/Endpoint/JBHHAD

Organizations & group practices 4

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1003956624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14321 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208624",
            "telephone_number": "405-342-0255",
            "fax_number": "405-610-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14321 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208624",
            "telephone_number": "405-342-0255",
            "fax_number": "405-610-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ MEJIA",
        "first_name": "GERARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "25202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Choctaw, OK

Sources for this page

Verify at the official NPI Registry.