Individual provider Active NPI

Araceli Monique Fuentes-Lopez, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1134913346
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
806164 Issued in TX
Practice address
11673 Jollyville Rd Ste B201
Austin, TX 78759-4200
Phone
(512) 579-0304
Fax
(512) 579-0320
NPI assigned
Apr 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 806164 TX Primary

Addresses

Primary practice location

11673 Jollyville Rd Ste B201
Austin, TX 78759-4200

Mailing address

11673 Jollyville Rd Ste B201
Austin, TX 78759-4200
Phone (512) 579-0304

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250613000851 TX Practitioner - Physician Assistant 8325559750 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
806164TXMDPhysician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1743724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1134913346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11673 JOLLYVILLE RD STE B201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594200",
            "telephone_number": "512-579-0304",
            "fax_number": "512-579-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11673 JOLLYVILLE RD STE B201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594200",
            "telephone_number": "512-579-0304",
            "fax_number": "512-579-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES-LOPEZ",
        "first_name": "ARACELI",
        "middle_name": "MONIQUE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-04",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "806164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.