Individual provider Active NPI

Virgilio Ignacio Lopez, M.D.

  • Anesthesiology Physician
  • Dededo, GU
National Provider Identifier
1255438347
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M-1774 Issued in GU
Practice address
133 Route 3
Dededo, GU 96929-6911
Phone
(671) 645-5500
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9341 NV
Anesthesiology Physician 207L00000X M-1774 GU Primary

Addresses

Primary practice location

133 Route 3
Dededo, GU 96929-6911

Mailing address

PO Box 11258
Tamuning, GU 96931-1258
Phone (671) 688-8181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, GU2 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
I20120521000476 NV Practitioner - Anesthesiology 9931362456 Reassigns benefits to 4 organizations
I20130805000448 GU Practitioner - Anesthesiology 9931362456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Office Anesthesia Consultants LLCGroup PAC ID 6901173509, 11 clinicians

Practice addresses (Care Compare)

6402 McLeod Dr
Suite 2
Las Vegas, NV 89120-4406
Phone (702) 487-5823

Merit-based Incentive Payment System (MIPS)

Final score
89.7 of 100Reported as group
Quality
82.63
Promoting interoperability
100
Improvement activities
40
Cost
83.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9341NVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Dec 1, 2018 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 1, 2020 Accepting new patients
Office Anesthesia Consultants LLC Anesthesiology CurrentSince Aug 28, 2023 Accepting new patients
Optum Medical Group Rhodes P C Anesthesiology Current Accepting new patients
Guam Healthcare Development Incorporated CurrentSince Aug 1, 2015 Accepting new patients
Valley Anesthesiology Consultants-Beckett-PLLC Anesthesiology CurrentSince May 14, 2012 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 1, 2020 Accepting new patients
Henderson Anesthesia LLC Anesthesiology Past Accepting new patients
Guam Memorial Hospital PastSince Jun 5, 2013 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

10120 S Eastern Ave
#230
Henderson, NV 89052

1110 Wigwam Pkwy
Henderson, NV 89074
Phone (702) 564-1344

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

2450 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8660

6402 McLeod Dr
Ste 2
Las Vegas, NV 89120
Phone (702) 325-1711

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2565 E Flamingo Rd
Las Vegas, NV 89121
Phone (702) 697-7900

Organizations & group practices 9

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1255438347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11258",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969311258",
            "telephone_number": "671-688-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ROUTE 3",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969296911",
            "telephone_number": "671-645-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "VIRGILIO",
        "middle_name": "IGNACIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "9341",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GU",
            "license": "M-1774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dededo, GU

Sources for this page

Verify at the official NPI Registry.