Individual provider Active NPI

Juan Alejandro Lopez

  • Psychiatric/Mental Health Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1245949361
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2342360 Issued in MA
Practice address
50 Tower Office Park
Woburn, MA 01801-2113
Phone
(339) 476-1209
NPI assigned
Nov 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2342360 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2342360 MA Primary

Addresses

Primary practice location

50 Tower Office Park
Woburn, MA 01801-2113

Mailing address

30 Pear Tree Rd
Haverhill, MA 01830-2338
Phone (978) 914-5525

Other practice location 1

30 Pear Tree Rd
Haverhill, MA 01830-2338
Phone (978) 914-5525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20241122002884 MA Practitioner - Nurse Practitioner 2264967546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

144 N Rd
Suite 3450
Sudbury, MA 01776-1156
Phone (978) 233-3054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2342360MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

144 North Rd
Ste 3450
Sudbury, MA 01776
Phone (978) 233-3054

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

50 Tower Office Park
Woburn, MA 01801
Phone (339) 345-2359

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1245949361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PEAR TREE RD",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018302338",
            "telephone_number": "978-914-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 TOWER OFFICE PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012113",
            "telephone_number": "339-476-1209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Pear Tree Rd",
            "address_purpose": "LOCATION",
            "city": "Haverhill",
            "state": "MA",
            "postal_code": "018302338",
            "country_code": "US",
            "telephone_number": "978-914-5525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JUAN",
        "middle_name": "ALEJANDRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-17",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2342360",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2342360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.