Individual provider Active NPI

Jose Baterina Lopez, MD

  • Family Medicine Physician
  • Burton, MI
National Provider Identifier
1154305241
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
JL047858 Issued in MI
Practice address
4085 S Center Rd Ste 2
Burton, MI 48519-1957
Phone
(810) 715-0349
Fax
(810) 768-3446
NPI assigned
Dec 1, 2005
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X JL047858 MI Primary

Addresses

Primary practice location

4085 S Center Rd Ste 2
Burton, MI 48519-1957

Mailing address

4085 S Center Rd Ste 2
Burton, MI 48519-1957
Phone (810) 715-0349

Other identifiers 1

IdentifierTypeStateIssuer
2621432MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060329000335 MI Practitioner - General Practice 7517973902 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JL047858MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Health Center PC CurrentSince Dec 1, 2022 Accepting new patients
Emergency Medical Centre of Flint, Inc. Past Accepting new patients
Emergency Medical Centre of Flint Past Accepting new patients

Locations

4085 S Center Rd
Ste 2
Burton, MI 48519
Phone (810) 742-4320

5095 W Bristol Rd
Ste B
Flint, MI 48507
Phone (810) 252-8320

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1154305241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 S CENTER RD STE 2",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191957",
            "telephone_number": "810-715-0349",
            "fax_number": "810-768-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 S CENTER RD STE 2",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191957",
            "telephone_number": "810-715-0349",
            "fax_number": "810-768-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSE",
        "middle_name": "BATERINA",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JL047858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2621432",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

Verify at the official NPI Registry.