Coronel Einna-Ernest Lopez, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10060 Issued in AZ

Practice address

5325 Grape Rd Ste C
Mishawaka, IN 46545-1474

Phone

(574) 404-8405

Fax

(574) 314-9034

NPI assigned

Dec 3, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IN2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100Reported as group

Quality

84.44

Promoting interoperability

99

Improvement activities

40

Cost

70.78

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Navajo Health Foundation-Sage Memorial Hospital Inc

  • Critical Access Hospital Clinic/Center
  • Ganado, AZ
  • NPI 1518957398

  W-2 Managing Employee

  CMS ownership

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.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028

  IN

  Medicare reassignment Care Compare group NPD
• Advanced Downtown Aquatic Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • West Branch, MI
  • NPI 1861850547
  Medicare reassignment
• Athletico LTD

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Athletico, LTD

  • Clinic/Center
  • Schererville, IN
  • NPI 1689974131

  Physical Therapist

  NPD
• Athletico LTD

  • Physical Therapist
  • Elmhurst, IL
  • NPI 1700130887
  NPD (past)
• Community Rehabilitation Services,PC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Rose City, MI
  • NPI 1669424776
  NPD (past)

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1013252089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 GRAPE RD STE C",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451474",
            "telephone_number": "574-404-8405",
            "fax_number": "574-314-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CORONEL",
        "middle_name": "EINNA-ERNEST",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-03",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen A Long, APRN-BC, ND
• Kyla Long
• Beth Ann Longbrake
• Jenny Lopez Alvarez, NP
• Alyssa G Lopez
• Jose Luis Lopez Jr., M.D.
• Marivel Lopez, MSW
• Sydney Abigail Lopez
• Mayelin Lora-Williams, RD
• Lori Lupresto, LMHC, LLC

• Physical Therapist in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.