Individual provider Active NPI

Jose Alberto Lopez-Vera, MD

  • Surgery Physician
  • Canton, GA
National Provider Identifier
1225598451
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
98474 Issued in GA
Practice address
470 Northside Cherokee Blvd Ste 230
Canton, GA 30115-8029
Phone
(770) 924-9656
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 98474 GA Primary

Addresses

Primary practice location

470 Northside Cherokee Blvd Ste 230
Canton, GA 30115-8029

Mailing address

470 Northside Cherokee Blvd Ste 230
Canton, GA 30115-8029
Phone (770) 924-9656

Other practice location 1

22999 Highway 59 N
Kingwood, TX 77339-4412
Phone (281) 348-8000

Other practice location 2

22999 Highway 59 N
Kingwood, TX 77339-4412
Phone (321) 348-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240821001075 GA Practitioner - General Surgery 2264767326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry NE
Atlanta, GA 30342-1606

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

4450 Calibre Crossing NW
Acworth, GA 30101-4104

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC Surgery CurrentSince Sep 1, 2024 Accepting new patients

Locations

4450 Calibre Xing NW
Ste 1110
Acworth, GA 30101
Phone (770) 721-9420

470 Northside Cherokee Blvd
Ste 230
Canton, GA 30115
Phone (770) 721-9460

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

900 Towne Lake Pkwy
Ste 412
Woodstock, GA 30189
Phone (709) 249-6567

Interoperability endpoints

  • Direct secure messaging: jose.lopezvera@hca9.eclinicaldirectplus.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1225598451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 NORTHSIDE CHEROKEE BLVD STE 230",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158029",
            "telephone_number": "770-924-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTHSIDE CHEROKEE BLVD STE 230",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158029",
            "telephone_number": "770-924-9656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22999 Highway 59 N",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773394412",
            "country_code": "US",
            "telephone_number": "281-348-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22999 Highway 59 N",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773394412",
            "country_code": "US",
            "telephone_number": "321-348-3321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ-VERA",
        "first_name": "JOSE",
        "middle_name": "ALBERTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "98474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.