Individual provider Active NPI

Reenie Lopez, PA-C

  • Medical Physician Assistant
  • Sarasota, FL
National Provider Identifier
1215042197
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109538 Issued in FL
Practice address
1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone
(941) 757-4810
Fax
(941) 757-4813
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109538 FL Primary

Addresses

Primary practice location

1700 S Tamiami TRL
Sarasota, FL 34239-3509

Mailing address

10920 Technology Terrace
Lakewood Ranch, FL 34211-4930
Phone (941) 757-4810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170830003083 FL Practitioner - Physician Assistant 2365502457 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Urology Specialists Current Accepting new patients
Genesiscare USA of Florida LLC Past Accepting new patients
Community Medicine Associates PastSince Mar 22, 2020 Accepting new patients

Locations

842 Sunset Lake Blvd
Ste 403
Venice, FL 34292
Phone (941) 485-3351

Interoperability endpoints

  • Direct secure messaging: reenielopez@fus.medalliesdirect.net

Organizations & group practices 4

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1215042197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 TECHNOLOGY TERRACE",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342114930",
            "telephone_number": "941-757-4810",
            "fax_number": "941-757-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393509",
            "telephone_number": "941-757-4810",
            "fax_number": "941-757-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "REENIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.