Individual provider Active NPI

Angel Luis Lopez, M.D.

  • General Practice Physician
  • Cidra, PR
National Provider Identifier
1295802890
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
13829 Issued in PR
Practice address
RR 2 Box 5678
Cidra, PR 00739-9679
Phone
(787) 376-6096
Fax
(787) 738-9476
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13829 PR Primary

Addresses

Primary practice location

RR 2 Box 5678
Cidra, PR 00739-9679

Mailing address

RR 2 Box 5678
Cidra, PR 00739-9679
Phone (787) 376-6096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20060406000126 PR Practitioner - General Practice 6507875325 Practice locations: Cayey, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 Ave Luis Munoz Rivera S
Suite 201
Cayey, PR 00736-4746
Phone (787) 263-9580

National Provider Directory

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295802890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 5678",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007399679",
            "telephone_number": "787-376-6096",
            "fax_number": "787-738-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 5678",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007399679",
            "telephone_number": "787-376-6096",
            "fax_number": "787-738-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ANGEL",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "13829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cidra, PR

Sources for this page

Verify at the official NPI Registry.