Individual provider Active NPI

Tania Lopez, D.O.

  • Gastroenterology Physician
  • Sebastian, FL
National Provider Identifier
1124453626
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS12965 Issued in FL
Practice address
7915 83Rd Ave
Sebastian, FL 32958-3282
Phone
(772) 589-0580
Fax
(877) 291-0858
NPI assigned
Sep 4, 2013
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS12965 FL
Internal Medicine Physician 207R00000X UO3569 FL
Gastroenterology Physician 207RG0100X ML0512965 FL
Gastroenterology Physician 207RG0100X OS12965 FL Primary

Addresses

Primary practice location

7915 83Rd Ave
Sebastian, FL 32958-3282

Mailing address

7915 83Rd Ave
Sebastian, FL 32958-3282
Phone (772) 589-0580

Other practice location 1

8005 83rd Ave Ste 1
Sebastian, FL 32958-3244
Phone (772) 589-0580

Other identifiers 2

IdentifierTypeStateIssuer
106666600MedicaidFL
0137977-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150127000057 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 3779807516 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

7915 83Rd Ave
Sebastian, FL 32958-3282
Phone (772) 589-0580

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91
Upper gastrointestinal (GI) endoscopy for acid reflux180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UO3569FLMDInternal Medicine Physician
ML0512965FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc. Internal Medicine CurrentSince Aug 26, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
24 On Physicians, PC CurrentSince Oct 1, 2017 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 26, 2019 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
24 On Physicians, P.C. CurrentSince Oct 1, 2017 Accepting new patients
Stewart and Stewart a Medical Corporation Internal Medicine Past Accepting new patients

Locations

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

12920 US Highway 1
Ste B
Sebastian, FL 32958
Phone (772) 228-9808

7915 Bay St
Sebastian, FL 32958
Phone (772) 388-4370

8000 Ron Beatty Blvd
Ste A-3
Sebastian, FL 32976
Phone (772) 664-1388

8005 Bay St
Ste 1
Sebastian, FL 32958
Phone (561) 388-2110

3745 11th Cir
Ste 101
Vero Beach, FL 32960
Phone (561) 299-3511

3745 11th Cir
Ste 103
Vero Beach, FL 32960
Phone (772) 567-4825

3745 11th Cir
Ste 105
Vero Beach, FL 32960
Phone (772) 564-2485

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1124453626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7915 83RD AVE",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583282",
            "telephone_number": "772-589-0580",
            "fax_number": "877-291-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 83RD AVE",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583282",
            "telephone_number": "772-589-0580",
            "fax_number": "877-291-0858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8005 83rd Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Sebastian",
            "state": "FL",
            "postal_code": "329583244",
            "country_code": "US",
            "telephone_number": "772-589-0580",
            "fax_number": "772-589-0760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "TANIA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS12965",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO3569",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ML0512965",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "OS12965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106666600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137977-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

Verify at the official NPI Registry.