Ivelisse Lopez, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

01100291A Issued in IN

Practice address

11104 Parkview Circle Dr Ste 310
Fort Wayne, IN 46845-1733

Phone

(260) 266-5230

Fax

(260) 458-5972

NPI assigned

Feb 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, GA2 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

Specialty

Gastroenterology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Archbold Medical Group, Inc.Group PAC ID 8123196383, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Archbold Medical Group, Inc.

  • Surgery Physician
  • Thomasville, GA
  • NPI 1831353036
  Medicare reassignment Care Compare group NPD
• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment NPD
• Piedmont Specialty Hospital Billing LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1699290510
  Medicare reassignment NPD
• Tift Regional Health System Inc

  dba Southwell Mobile Clinic

  • Family Medicine Physician
  • Tifton, GA
  • NPI 1881203305
  Medicare reassignment NPD
• Gastroenterology Associate of Central Florida

  dba Center for Digestive Health

  • Gastroenterology Physician
  • Orlando, FL
  • NPI 1750320099
  Medicare reassignment
• Parkview Health System Inc

  dba Parkview Physicians Group

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Care Compare group
• Archbold Medical Group, Inc.

  dba Archbold Pulmonary Medicine & Critical Care Services

  • Pulmonary Disease Physician
  • Thomasville, GA
  • NPI 1972097293
  NPD
• Lee Health System Inc

  dba Lee Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  dba LCH-Golisano Peds PC Bayshore

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John D Archbold Memorial Hospital Inc

  dba Archbold Memorial

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702
  Care Compare affiliation
• John D. Archbold Memorial Hospital, Inc.

  dba John D. Archbold Memorial Hospital - Rehab

  • Rehabilitation Hospital Unit
  • Thomasville, GA
  • NPI 1104867738
  Care Compare affiliation

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1316913171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 S OSCEOLA AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328065431",
            "telephone_number": "407-843-0443",
            "fax_number": "407-843-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR STE 310",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451733",
            "telephone_number": "260-266-5230",
            "fax_number": "260-458-5972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2880 S Osceola Ave",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328065431",
            "country_code": "US",
            "telephone_number": "407-843-0443",
            "fax_number": "407-843-0442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "IVELISSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME82595",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01100291A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262579200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Looney
• Gabrielle Looney, RBT
• Veronica Looney, RBT
• Antonia Lopez
• Esther Lopez, RBT
• Jennifer Lopez, RBT
• Kelsea May Lopez, RPH, PHARM D
• Louis Alfred Lopez, MD
• Mariana Lopez
• Taylor Leigh Lopez

• Gastroenterology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.

Verify at the official NPI Registry.