Individual provider Active NPI

Javier Lopez, MD

  • Surgery Physician
  • Cleveland, OH
National Provider Identifier
1154319804
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2653301 Issued in OH
Practice address
5158 Broadway Ave
Cleveland, OH 44127-1533
Phone
(216) 271-0711
Fax
(216) 271-5473
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2653301 OH Primary

Addresses

Primary practice location

5158 Broadway Ave
Cleveland, OH 44127-1533

Mailing address

5158 Broadway Ave
Cleveland, OH 44127-1533
Phone (216) 271-0711

Other identifiers 1

IdentifierTypeStateIssuer
0080433MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160720001633 OH Order and Referring Only - General PracticePractitioner - General PracticePractitioner - General SurgeryPractitioner - Surgical Oncology 6103119763

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2653301OHMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154319804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5158 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271533",
            "telephone_number": "216-271-0711",
            "fax_number": "216-271-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5158 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271533",
            "telephone_number": "216-271-0711",
            "fax_number": "216-271-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JAVIER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "2653301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080433",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.