Stacey Lopez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13099 Issued in TX

Practice address

621 SW Johnson Ave Ste C
Burleson, TX 76028-5834

Phone

(817) 766-7421

Fax

(817) 447-8100

NPI assigned

Jan 7, 2020

Sex

Female

Sole proprietor

No

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prestige Dermatology PLLCGroup PAC ID 2365752813, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

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

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.

• Prestige Dermatology PLLC

  • Dermatology Physician
  • Burleson, TX
  • NPI 1962878843
  Medicare reassignment Care Compare group
• Derm on Demand, LLC

  • Dermatology Physician
  • Carrollton, TX
  • NPI 1780234237
  Medicare reassignment
• Wellworx Dermatology PLLC

  • Dermatology Physician
  • Frisco, TX
  • NPI 1164244703
  NPD (past)

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1134769292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SW JOHNSON AVE STE C",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285834",
            "telephone_number": "817-718-3571",
            "fax_number": "817-447-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SW JOHNSON AVE STE C",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285834",
            "telephone_number": "817-766-7421",
            "fax_number": "817-447-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "STACEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lone Star Orthopaedic and Spine Specialists, PLLC
• Lone Star Progressive Medicine of Burleson PA
• Lone Star Radiology Services PLLC
• Lonestar Speech Therapy, PLLC
• Lookup Properties Inc.
• Ashley Lott, LPC
• James David Lowery, D.O.
• Jose Lozano
• Jose Javier Lozano, D.O., M.S,
• Holli Mae Lueg, PA-C

• Physician Assistant in Burleson, TX
• Providers in Burleson, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.