Gustavo A Lopez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

42153 Issued in AZ

Practice address

9169 W Van Buren St
Tolleson, AZ 85353-2942

Phone

(602) 283-5732

Fax

(602) 314-4579

NPI assigned

Jul 8, 2009

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

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

American Family Medicine LLCGroup PAC ID 5092007427, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advance Home Health Care, LLC Home health agency, Mesa, AZ, CCN 037462
• American Home Health Services, Inc. Home health agency, Mesa, AZ, CCN 037426

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

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

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.

• American Family Medicine LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1477908085
  Medicare reassignment Care Compare group NPD
• American Family Medicine LLC

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1164287124
  NPD
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  NPD (past)
• Sun Life Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Eloy, AZ
  • NPI 1588876429
  NPD (past)
• Sun Life Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Florence, AZ
  • NPI 1902278252
  NPD (past)

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

• Advance Home Health Care LLC

  • Home Health Agency
  • Mesa, AZ
  • NPI 1659751006
  Care Compare affiliation
• American Home Health Services, Inc

  • Home Health Agency
  • Mesa, AZ
  • NPI 1114279536
  Care Compare affiliation

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1023247202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9169 W VAN BUREN ST",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853532942",
            "telephone_number": "602-283-5732",
            "fax_number": "602-314-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9169 W VAN BUREN ST",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853532942",
            "telephone_number": "602-283-5732",
            "fax_number": "602-314-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "GUSTAVO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "42153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "441076",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Logistics LLC
• Living Hope Arcadia LLC
• LLC Deeply Rooted Family & Life Services
• Jamilah Q Logan, PH.D.
• Anastasia Jessica Lopez, LPN
• Johanna Lizette Lopez, PHARMD
• Matthew Ryan Lopez, O.D.
• Denna L Lorona, SLPA
• Kristen Jo Lorton, MA
• Wendy Lotegeluaki, CNM

• Family Medicine Physician in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.