Individual provider Active NPI

Dara Nally de Antunano Lopes, MD

  • Student in an Organized Health Care Education/Training Program
  • Santa Cruz, CA
National Provider Identifier
1154162741
Registry record updated Nov 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
1154162741 Issued in CA
Practice address
1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone
(831) 462-7296
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 1154162741 CA Primary

Addresses

Primary practice location

1555 Soquel Dr
Santa Cruz, CA 95065-1705

Mailing address

1555 Soquel Dr
Santa Cruz, CA 95065-1794
Phone (831) 462-7296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260219003172 CA Order and Referring Only - Family PracticePractitioner - Family Practice 0446731251

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1154162741CAMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: dlopes724603@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1154162741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651794",
            "telephone_number": "831-462-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPES",
        "first_name": "DARA",
        "middle_name": "NALLY DE ANTUNANO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "1154162741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.