Active NPI
J. Antonio G Lopez, M.D.
- Cardiovascular Disease Physician
- Boise, ID
National Provider Identifier
1326011503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- M-9898
- Practice address
- 6140 W Curtisian Ave
Suite 200
Boise, ID 83704-0107 - Phone
- (208) 367-4278
- Fax
- (208) 367-5200
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | G56032 | CA | |
| Cardiovascular Disease Physician | 207RC0000X | M-9898 | ID | Primary |
Addresses
Primary practice location
6140 W Curtisian Ave
Suite 200
Boise, ID 83704-0107
Mailing address
3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-5170
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G560320 | Medicaid | CA | |
| P00208355 | Other | CA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G56032 | CA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern California Cardiology Associates Medical Group Inc | Cardiovascular Disease | Past | Accepting new patients |
| Prairie Cardiovascular Consultants LTD | Cardiovascular Disease | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Sacramento, CA
- NPI 1467444711
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1982714218
Cardiovascular Disease
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1326011503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 E GOLDSTONE WAY",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421026",
"telephone_number": "208-367-5170",
"fax_number": "208-367-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6140 W CURTISIAN AVE",
"address_2": "SUITE 200",
"city": "BOISE",
"state": "ID",
"postal_code": "837040107",
"telephone_number": "208-367-4278",
"fax_number": "208-367-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "J. ANTONIO",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "G56032",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "ID",
"license": "M-9898",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G560320",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00208355",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.