Individual provider Active NPI

Alfredo Lopez, MD

  • Obstetrics & Gynecology Physician
  • Syracuse, NY
National Provider Identifier
1033188115
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2021231 Issued in NY
Practice address
516 Prospect Ave
Syracuse, NY 13208
Phone
(315) 703-5200
Fax
(315) 703-5201
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2021231 NY Primary

Addresses

Primary practice location

516 Prospect Ave
Syracuse, NY 13208

Mailing address

516 Prospect Ave
OBGYN
Syracuse, NY 13208
Phone (315) 703-5200

Other identifiers 1

IdentifierTypeStateIssuer
01665049MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040707001196 NY Practitioner - Obstetrics/Gynecology 3577541564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021231NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Community Medical, PC CurrentSince Jun 1, 2014 Accepting new patients
Associates for Women's Medicine PLLC Obstetrics & Gynecology Past Accepting new patients
St. Joseph's Physician Health, P.C. Past Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

4900 Broad Rd
Ste 4H
Syracuse, NY 13215
Phone (315) 492-5678

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: alopez37383@direct.upstate.edu

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.

Hospital & facility affiliations 1

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1033188115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 PROSPECT AVE",
            "address_2": "OBGYN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13208",
            "telephone_number": "315-703-5200",
            "fax_number": "315-703-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13208",
            "telephone_number": "315-703-5200",
            "fax_number": "315-703-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ALFREDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "2021231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01665049",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.