Individual provider Active NPI

John Lopez, DO

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
National Provider Identifier
1245692706
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
010528 Issued in AZ
Practice address
5652 E Baseline Rd
Mesa, AZ 85206-4713
Phone
(480) 567-0350
NPI assigned
Mar 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MB11177300 NJ
Physical Medicine & Rehabilitation Physician 208100000X 010528 AZ Primary

Addresses

Primary practice location

5652 E Baseline Rd
Mesa, AZ 85206-4713

Mailing address

8102 E Cypress St
Scottsdale, AZ 85257-2815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210720002400 NJ Practitioner - Physical Medicine and Rehabilitation 0446522270 Reassigns benefits to 1 organization
I20240215001892 AZ Practitioner - Physical Medicine and Rehabilitation 0446522270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5652 E Baseline Rd
Mesa, AZ 85206-4713
Phone (480) 567-0350

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kessler Professional Services LLC CurrentSince Jul 1, 2021 Accepting new patients
JKL Restorative PLLC Physical Medicine & Rehabilitation CurrentSince May 6, 2024 Accepting new patients

Locations

5652 E Baseline Rd
Mesa, AZ 85206
Phone (480) 477-7112

1199 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 414-4755

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Organizations & group practices 2

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 4

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1245692706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8102 E CYPRESS ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852572815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5652 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064713",
            "telephone_number": "480-567-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MB11177300",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "010528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.