Kiara Michelle Lopez de Latchum, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA059530 Issued in PA

Practice address

4301 5TH Street Hwy Ste 101
Temple, PA 19560-1739

Phone

(610) 208-8800

Fax

(610) 898-1336

NPI assigned

Oct 30, 2017

Last updated

Sep 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kiara Aguayo Lopez Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klopezdelatchum1@aacppp-pa.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Penn State Health Medical Group, LLC

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  • Harrisburg, PA
  • NPI 1861988644
  Medicare reassignment
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD
• St. Joseph Medical Group

  • Family Medicine Physician
  • Reading, PA
  • NPI 1184754657
  NPD
• Penn State Health Medical Group, LLC

  • Dermatology Physician
  • Camp Hill, PA
  • NPI 1407500143
  NPD (past)

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726963200000",
    "number": "1063924181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 LANCASTER AVE",
            "city": "READING",
            "state": "PA",
            "postal_code": "196071540",
            "telephone_number": "484-467-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 5TH STREET HWY STE 101",
            "city": "TEMPLE",
            "state": "PA",
            "postal_code": "195601739",
            "telephone_number": "610-208-8800",
            "fax_number": "610-898-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ DE LATCHUM",
        "first_name": "KIARA",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2024-09-22",
        "certification_date": "2024-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIARA",
            "last_name": "AGUAYO LOPEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kidspeace Children's Hospital, Inc.
• Kidspeace National Centers, Inc.
• Brian S Klee, DPM
• Taylor Kulak
• Heather Lampron
• Love Your Neighbor Services (Eve's Grace Home Care Agency)
• Olivia Lubas, PA-C
• Julie Lurwick, CRNP
• Diane Luu
• Noel Chin Martinez, MA

• Medical Physician Assistant in Temple, PA
• Providers in Temple, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.