Active NPI
Sara Lopez, PA
- Physician Assistant
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA218030
- Practice address
- 1500 N Ritter Ave
Indianapolis, IN 46219-3027 - Phone
- (317) 355-5041
- NPI assigned
- Nov 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | PA218030 | OR | Primary |
Addresses
Primary practice location
1500 N Ritter Ave
Indianapolis, IN 46219-3027
Mailing address
451 E Market St Apt 434
Indianapolis, IN 46204-2697
Phone (847) 915-9466
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988
21430 SW Langer Farms Pkwy
Suite 158
Sherwood, OR 97140-9141
Phone (971) 808-0655
22262 NE Glisan St
Gresham, OR 97030-8553
Phone (503) 489-2024
2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone (503) 666-5050
2870 SW Cedar Hills Blvd
Beaverton, OR 97005-1354
Phone (503) 646-9222
3505 N Williams Ave
Portland, OR 97227-1437
Phone (503) 396-4950
4800 SW 76TH Ave
Portland, OR 97225-1804
Phone (971) 808-0665
9361 SE 82ND Ave
Happy Valley, OR 97086-3645
Phone (503) 457-4301
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.62 of 100
- Quality
- 77.21
- Promoting interoperability
- 99.06
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.51 of 100
- Quality
- 95.35
- Improvement activities
- 40
- Cost
- 78.59
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Clinics LLC | Current | Accepting new patients | |
| Legacy Salmon Creek Hospital | Past | Accepting new patients |
Locations
2870 SW Cedar Hills Blvd
Beaverton, OR 97005
Phone (503) 646-9222
22262 NE Glisan St
Gresham, OR 97030
Phone (503) 489-2024
2850 SE Powell Valley Rd
Gresham, OR 97080
Phone (503) 666-5050
3 Monroe Pkwy
Ste X
Lake Oswego, OR 97035
Phone (503) 679-3748
1900 McLoughlin Blvd
Ste 67
Oregon City, OR 97045
4800 SW 76th Ave
Portland, OR 97225
Phone (971) 808-0665
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
21430 SW Langer Farms Pkwy
Ste 158
Sherwood, OR 97140
Phone (971) 808-0655
21900 Willamette Dr
Ste 209
West Linn, OR 97068
Phone (971) 274-0038
200 NE Mother Joseph Pl
Ste 410
Vancouver, WA 98664
Phone (503) 413-3580
305 SE Chkalov Dr
Ste 170
Vancouver, WA 98683
Phone (360) 799-3912
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Indianapolis, IN
- NPI 1710932736
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gresham, OR
- NPI 1255354700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1316602428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 E MARKET ST APT 434",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462042697",
"telephone_number": "847-915-9466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 N RITTER AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462193027",
"telephone_number": "317-355-5041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "SARA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-03",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA218030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.