Individual provider Active NPI

Michael Anthony Lopez, MD

  • Ophthalmology Physician
  • Dayton, OH
National Provider Identifier
1205192135
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35.152105 Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1873
Phone
(937) 641-4000
Fax
(937) 641-4500
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35.152105 OH Primary
Ophthalmology Physician 207W00000X ME123089 FL
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X ME123089 FL

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1873

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other practice location 1

3115 W Swann Ave
Tampa, FL 33609-4617
Phone (813) 492-2020

Other practice location 2

5800 49th St N Ste S108
St Petersburg, FL 33709-2146
Phone (727) 390-3937

Other practice location 3

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 641-4000

Other practice location 4

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-4000

Other practice location 5

403 Vonderburg Dr
Brandon, FL 33511-5982
Phone (813) 681-1122

Other practice location 6

10080 Balaye Run Dr
Tampa, FL 33619-7902
Phone (727) 767-4393

Other identifiers 1

IdentifierTypeStateIssuer
0078595MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170713001087 FL Practitioner - Ophthalmology 6305136219 Reassigns benefits to 1 organization
I20241206002418 OH Practitioner - Ophthalmology 6305136219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.32 of 100Reported as group
Quality
96.85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.152105OHMDOphthalmology Physician
ME123089FLMDPediatric Ophthalmology and Strabismus Specialist Physician Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Ophthalmology CurrentSince Jan 6, 2025 Accepting new patients
Shriners Hospitals for Children CurrentSince May 22, 2025 Accepting new patients
Shriners Hospitals for Children CurrentSince May 22, 2025 Accepting new patients
Hess Pediatric Ophthalmology Specialist Ophthalmology CurrentSince Jul 1, 2017 Accepting new patients

Locations

601 5th St S
Ste 601
St Petersburg, FL 33701
Phone (727) 892-4393

710 94th Ave N
Ste 309
St Petersburg, FL 33702
Phone (727) 213-3330

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

1 Childrens Plz
#2W
Dayton, OH 45404
Phone (513) 872-6000

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

3333 W Tech Rd
Miamisburg, OH 45342
Phone (937) 641-3400

Organizations & group practices 5

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1205192135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3115 W Swann Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336094617",
            "country_code": "US",
            "telephone_number": "813-492-2020",
            "fax_number": "813-492-2099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5800 49th St N Ste S108",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337092146",
            "country_code": "US",
            "telephone_number": "727-390-3937",
            "fax_number": "727-390-3940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-641-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 Vonderburg Dr",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115982",
            "country_code": "US",
            "telephone_number": "813-681-1122",
            "fax_number": "813-684-4924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10080 Balaye Run Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336197902",
            "country_code": "US",
            "telephone_number": "727-767-4393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35.152105",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME123089",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "FL",
            "license": "ME123089",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078595",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.