Individual provider Active NPI

Alfonso Lopez, AGACNP

  • Acute Care Nurse Practitioner
  • Brownsville, TX
National Provider Identifier
1235745456
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1014400 Issued in TX
Practice address
100 E Alton Gloor Blvd
Brownsville, TX 78526-3328
Phone
(956) 350-7000
NPI assigned
Sep 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1014400 TX Primary

Addresses

Primary practice location

100 E Alton Gloor Blvd
Brownsville, TX 78526-3328

Mailing address

6661 Tallowood Cir
Brownsville, TX 78521-7031
Phone (956) 525-9582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210520000941 TX Practitioner - Nurse Practitioner 4385043504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensivist Medicine Services of TX, PLLCGroup PAC ID 3476915190, 35 clinicians

Practice addresses (Care Compare)

100 E Alton Gloor Blvd
Valley RGNL Med CNTR
Brownsville, TX 78526-3328
Phone (956) 350-7000

Hospital & facility affiliations

  • Valley Regional Medical Center Hospital, Brownsville, TX, CCN 450662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intensivist Medicine Services of TX, PLLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

100 E Alton Gloor Blvd
Brownsville, TX 78526
Phone (956) 350-7000

710 FM 1960 Rd W
Houston, TX 77090
Phone (281) 440-1000

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": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1235745456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6661 TALLOWOOD CIR",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785217031",
            "telephone_number": "956-525-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263328",
            "telephone_number": "956-350-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ALFONSO",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1014400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.