Ibonne Lopez Maso

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1020731 Issued in TX

Practice address

1701 NW 25TH St
Fort Worth, TX 76164-6850

Phone

(682) 707-5982

Fax

(682) 707-5984

NPI assigned

Jan 11, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Clinica Familiar Las Americas FW Inc

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1285449660
  NPD Authorized official

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1104697887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW 25TH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761646850",
            "telephone_number": "682-707-5982",
            "fax_number": "682-707-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NW 25TH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761646850",
            "telephone_number": "682-707-5982",
            "fax_number": "682-707-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ MASO",
        "first_name": "IBONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1020731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Michelle Longoria, PA
• Mary Lonsberry, FNP-C
• Gary Steve Looney, MT007903
• Kara Looten, PHYSICAL THERAPIST
• Katheryn Lopez Arjona, CBS
• Lopez Wellness, PLLC
• Omar Lopez-Flores, APRN
• Maria Cristina Lopez-Rosario, MD
• Staci E Lopez-Vergara, CPNP
• Angel Luis Lopez, DPM

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.