Individual provider Active NPI

Melissa Marie Lopez, OD

  • Optometrist
  • Lakeville, MN
National Provider Identifier
1114405271
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3590 Issued in MN
Practice address
18275 Kenrick Ave
Lakeville, MN 55044-7306
Phone
(952) 892-0028
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3590 MN Primary

Addresses

Primary practice location

18275 Kenrick Ave
Lakeville, MN 55044-7306

Mailing address

1078 Cherokee Ave
West St Paul, MN 55118-1101
Phone (651) 604-7025

Other practice location 1

8900 Minnesota 7
St. Louis Park, MN 55426
Phone (952) 933-4858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825002800 MN Practitioner - Optometry 2567846546 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Eye Care, PA Optometrist CurrentSince Jul 27, 2022 Accepting new patients
St Paul Eye Clinic PA CurrentSince Sep 12, 2023 Accepting new patients
St Paul Eye Clinic PA CurrentSince Sep 12, 2023 Accepting new patients

Locations

851 W 78th St
Chanhassen, MN 55317
Phone (952) 252-1208

1215 Town Centre Dr
Ste 100
Eagan, MN 55123
Phone (651) 454-2526

18275 Kenrick Ave
Lakeville, MN 55044
Phone (952) 892-0028

1675 Beam Ave
Ste 100
Maplewood, MN 55109
Phone (651) 227-6634

7000 York Ave S
Minneapolis, MN 55435
Phone (952) 922-8118

15800 87th St NE
Otsego, MN 55330
Phone (763) 252-1316

6445 Richfield Pkwy
Richfield, MN 55423
Phone (612) 243-0201

21615 S Diamond Lake Rd
Rogers, MN 55374
Phone (763) 428-4831

2680 Snelling Ave N
Ste 110
Roseville, MN 55113
Phone (651) 631-2922

1093 Grand Ave
Saint Paul, MN 55105
Phone (651) 222-7343

14333 Highway 13 S
Savage, MN 55378
Phone (952) 226-1411

8900 Highway 7
St Louis Park, MN 55426
Phone (952) 933-4858

2080 Woodwinds Dr
Ste 110
Woodbury, MN 55125
Phone (651) 738-6500

2080 Woodwinds Dr
Ste 230
Woodbury, MN 55125
Phone (651) 578-6949

Interoperability endpoints

  • Direct secure messaging: mlopez@stpauleye.intellechartdirect.net

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Eye Clinic PA 20 clinicians

Practice addresses (Care Compare)

2080 Woodwinds Dr
Suite 230
Woodbury, MN 55125-2539
Phone (651) 578-6949

Merit-based Incentive Payment System (MIPS)

Final score
88.92 of 100Reported as group
Quality
89.37
Promoting interoperability
100
Improvement activities
40
Cost
73.71

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1114405271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 CHEROKEE AVE",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551181101",
            "telephone_number": "651-604-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447306",
            "telephone_number": "952-892-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Minnesota 7",
            "address_purpose": "LOCATION",
            "city": "St. Louis Park",
            "state": "MN",
            "postal_code": "55426",
            "country_code": "US",
            "telephone_number": "952-933-4858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.