Individual provider Active NPI

Roman Lopez

  • Physical Therapy Assistant
  • El Paso, TX
National Provider Identifier
1225514904
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2098176 Issued in TX
Practice address
11351 James Watt Dr
El Paso, TX 79936-6627
Phone
(915) 849-6602
NPI assigned
Jul 16, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 2098176 TX Primary

Addresses

Primary practice location

11351 James Watt Dr
El Paso, TX 79936-6627

Mailing address

13105 Kestrel Ave
Horizon City, TX 79928-6210
Phone (915) 235-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2098176TXMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Akomolafe Professional Corporation Single Specialty PastSince Dec 1, 2012 Accepting new patients

Organizations & group practices 1

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1225514904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 KESTREL AVE",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799286210",
            "telephone_number": "915-235-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11351 JAMES WATT DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366627",
            "telephone_number": "915-849-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ROMAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2098176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.