Individual provider Active NPI

Wilberto L Lopez, M.D.

  • Cardiovascular Disease Physician
  • Lake Mary, FL
National Provider Identifier
1275639544
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME 80778 Issued in FL
Practice address
910 Williston Park PT
Ste 1000
Lake Mary, FL 32746-2172
Phone
(407) 833-8028
Fax
(407) 833-8033
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME 80778 FL Primary
Nuclear Cardiology Physician 207UN0901X ME 80778 FL

Addresses

Primary practice location

910 Williston Park PT
Ste 1000
Lake Mary, FL 32746-2172

Mailing address

910 Williston Park PT
Ste 1000
Lake Mary, FL 32746-2172
Phone (407) 833-8028

Other identifiers 1

IdentifierTypeStateIssuer
35761OtherFLBCBS OF FL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050418000113 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 7315984788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Tufts University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 80778FLMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Volusia Healthcare Corporation CurrentSince Aug 16, 2021 Accepting new patients
Central Florida Cardiology Interpretations LLC CurrentSince Sep 3, 2004 Accepting new patients
Florida Hospital Healthcare Partners, Inc CurrentSince Nov 4, 2024 Accepting new patients
Southwest Volusia Healthcare Corporation CurrentSince Aug 16, 2021 Accepting new patients
Lake Cardiology PA Cardiovascular Disease Past Accepting new patients

Locations

1565 Saxon Blvd
Ste 201
Deltona, FL 32725
Phone (386) 532-1232

910 Williston Park Pt
Ste 1000
Lake Mary, FL 32746
Phone (407) 803-8028

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

1035 Town Center Dr
Orange City, FL 32763
Phone (386) 775-8229

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: wlopez70832@adventhealth.direct-ci.com

Organizations & group practices 5

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 6

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1275639544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WILLISTON PARK PT",
            "address_2": "STE 1000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462172",
            "telephone_number": "407-833-8028",
            "fax_number": "407-833-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WILLISTON PARK PT",
            "address_2": "STE 1000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462172",
            "telephone_number": "407-833-8028",
            "fax_number": "407-833-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "WILBERTO",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME 80778",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "FL",
            "license": "ME 80778",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "35761",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.