Active NPI
Miqueas Lopez
- Physician Assistant
- St Petersburg, FL
National Provider Identifier
1124729348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9117182
- Practice address
- 1200 7TH Ave N
St Petersburg, FL 33705-1300 - Phone
- (727) 825-1100
- NPI assigned
- Mar 14, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9117182 | FL | Primary |
Addresses
Primary practice location
1200 7TH Ave N
St Petersburg, FL 33705-1300
Mailing address
500 Dr Martin Luther King Jr St N Ste 303
St Petersburg, FL 33705-1470
Phone (727) 210-5253
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- St Petersburg, FL
- NPI 1396171518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686096000000",
"number": "1124729348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 DR MARTIN LUTHER KING JR ST N STE 303",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337051470",
"telephone_number": "727-210-5253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 7TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337051300",
"telephone_number": "727-825-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MIQUEAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-14",
"last_updated": "2023-06-07",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9117182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.