Individual provider Active NPI

Luz Angela Lopez, M.D

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1124081823
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33381 Issued in AZ
Practice address
3130 E Baseline Rd Ste 103
Mesa, AZ 85204-7290
Phone
(480) 539-7618
Fax
(480) 900-8884
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33381 AZ
Family Medicine Physician 207Q00000X 33381 AZ Primary

Addresses

Primary practice location

3130 E Baseline Rd Ste 103
Mesa, AZ 85204-7290

Mailing address

3130 E Baseline Rd Ste 103
Mesa, AZ 85204-7290
Phone (480) 539-7618

Other practice location 1

3305 E Greenway Rd Ste 6
Phoenix, AZ 85032-4509
Phone (602) 867-1252

Other practice location 2

6211 N 35th Ave
Phoenix, AZ 85017-1415
Phone (602) 242-5000

Other identifiers 1

IdentifierTypeStateIssuer
000490MedicaidAZ

Other names 1

  • Luz Angela Calderon Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140715001471 AZ Practitioner - Family PracticePractitioner - Pediatric Medicine 4789808775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Pediatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohana Kids and Family Kare LLCGroup PAC ID 5193156438, 3 clinicians

Practice addresses (Care Compare)

3305 E Greenway Rd
Suite 6
Phoenix, AZ 85032-4509
Phone (602) 867-1252

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33381AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohana Kids & Family Kare LLC Family Medicine CurrentSince Mar 26, 2020 Accepting new patients
Kids Kare Pediatrics Pediatrics Current Accepting new patients
Kids and Family Kare LLC Family Medicine PastSince Jun 25, 2023 Accepting new patients

Locations

3130 E Baseline Rd
Ste 103
Mesa, AZ 85204
Phone (480) 539-7618

6211 N 35th Ave
Phoenix, AZ 85017
Phone (602) 242-5000

6211 N 35th Ave
Ste 3
Phoenix, AZ 85017
Phone (602) 841-7718

3305 E Greenway Rd
Ste 6
Phoenix, AZ 85032
Phone (602) 867-1252

521 W Thomas Rd
Fl 2
Phoenix, AZ 85013
Phone (602) 252-1439

6211 N 35th Ave
Ste 1
Phoenix, AZ 85017
Phone (602) 242-5000

Interoperability endpoints

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1124081823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 E BASELINE RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047290",
            "telephone_number": "480-539-7618",
            "fax_number": "480-539-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E BASELINE RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047290",
            "telephone_number": "480-539-7618",
            "fax_number": "480-900-8884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3305 E Greenway Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850324509",
            "country_code": "US",
            "telephone_number": "602-867-1252",
            "fax_number": "480-605-2290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6211 N 35th Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850171415",
            "country_code": "US",
            "telephone_number": "602-242-5000",
            "fax_number": "480-605-2291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "LUZ",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "33381",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "33381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000490",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUZ",
            "last_name": "CALDERON",
            "middle_name": "ANGELA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.