NPIMap

Individual provider Active NPI

Martin J Lopez, MD

  • Interventional Pain Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1013905942
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
16998 Issued in OK
Practice address
4525 S Klein Ave
Ste 900
Oklahoma City, OK 73109-3845
Phone
(405) 636-1797
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 16998 OK
Interventional Pain Medicine Physician 208VP0014X 16998 OK Primary
Anesthesiology Physician 207L00000X 16998 OK

Addresses

Primary practice location

4525 S Klein Ave
Ste 900
Oklahoma City, OK 73109-3845

Mailing address

PO Box 99730
Oklahoma City, OK 73199-0001

Other identifiers 3

IdentifierTypeStateIssuer
4460958OtherOKAETNA
100096400AMedicaidOK
050032793OtherOKRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090205000172 OK Practitioner - Pain ManagementPractitioner - Anesthesiology 4486659216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Oklahoma College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4525 S Klein Ave
Suite 900
Oklahoma City, OK 73109-3839
Phone (405) 631-0300

Hospital & facility affiliations

  • Oklahoma Center for Orthopaedic & Multi-SP Hospital, Oklahoma City, OK, CCN 370212
  • Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16998OKMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin J Lopez MD PC Anesthesiology CurrentSince Sep 17, 2008 Accepting new patients
Summit Medical Center Interventional Pain Medicine Past Accepting new patients
Jackson County Memorial Hospital Authority Interventional Pain Medicine Past Accepting new patients

Locations

5350 S Western Ave
Ste 419
Oklahoma City, OK 73109
Phone (405) 634-4427

4525 S Klein Ave
Ste 900
Oklahoma City, OK 73109
Phone (405) 631-0300

Interoperability endpoints

  • Direct secure messaging: mlopez@direct.uspi.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Surgical Hospital of OklahomaOklahoma City, OK, CCN 370201 Hospital Limited Partnership Interest (1.58%) Feb 1, 2005

Owned or controlled facilities with NPI records 1

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

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1013905942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99730",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731990001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 S KLEIN AVE",
            "address_2": "STE 900",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093845",
            "telephone_number": "405-636-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OK",
            "license": "16998",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "16998",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "16998",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4460958",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096400A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050032793",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.