Individual provider Active NPI

Michael Joe Lao Lopez, C.R.N.P.

  • Nurse Practitioner
  • Sarasota, FL
National Provider Identifier
1245540145
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11013114 Issued in FL
Practice address
1901 Floyd St Ste 304
Sarasota, FL 34239-2932
Phone
(941) 261-0500
Fax
(941) 261-0505
NPI assigned
Oct 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11013114 FL Primary
Critical Care Medicine Registered Nurse 163WC0200X R162164 MD

Addresses

Primary practice location

1901 Floyd St Ste 304
Sarasota, FL 34239-2932

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other practice location 1

600 N Wolfe Ste
Baltimore, MD 21287-0006
Phone (410) 955-3628

Other identifiers 1

IdentifierTypeStateIssuer
039006200MedicaidMD

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
I20210616000228 FL Practitioner - Nurse Practitioner 8325221898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1901 Floyd St
Suite 304
Sarasota, FL 34239-2932
Phone (941) 261-0500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11013114FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Nurse Practitioner CurrentSince Aug 9, 2021 Accepting new patients
SMH Physician Services Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1901 Floyd St
Sarasota, FL 34239
Phone (941) 366-9222

1901 Floyd St
Ste 304
Sarasota, FL 34239
Phone (941) 261-0500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: michael.lopez@fpg.directbygreenway.com

Organizations & group practices 3

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 2

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": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1245540145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 FLOYD ST STE 304",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392932",
            "telephone_number": "941-261-0500",
            "fax_number": "941-261-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe Ste",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870006",
            "country_code": "US",
            "telephone_number": "410-955-3628",
            "fax_number": "410-955-6526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MICHAEL JOE",
        "middle_name": "LAO",
        "name_prefix": "Mr.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11013114",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MD",
            "license": "R162164",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039006200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.