Individual provider Active NPI

Javier Lopez, MD

  • Psychiatry Physician
  • Bridgeport, CT
National Provider Identifier
1023025327
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
044539 Issued in CT
Practice address
267 Grant St
Bridgeport, CT 06610-2805
Phone
(203) 384-3897
Fax
(203) 384-3950
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 044539 CT Primary
Geriatric Psychiatry Physician 2084P0805X 044539 CT

Addresses

Primary practice location

267 Grant St
Bridgeport, CT 06610-2805

Mailing address

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20061106000380 CT Practitioner - Psychiatry 6002813011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
044539CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Psychiatry CurrentSince Dec 16, 2013 Accepting new patients
Masonicare Primary Care Physicians PastSince Oct 1, 2001 Accepting new patients
Masonicare Behavioral Health, LLC Geriatric Psychiatry PastSince Dec 17, 2007 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

67 Masonic Ave
Fl 1
Wallingford, CT 06492
Phone (203) 265-0355

Interoperability endpoints

  • Direct secure messaging: jlopez133993@direct.ynhh.org

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 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1023025327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3897",
            "fax_number": "203-384-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3897",
            "fax_number": "203-384-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "044539",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CT",
            "license": "044539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.