Kevin Gerard Lopez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD2020-0934 Issued in NM

Practice address

4710 Jefferson St NE
Albuquerque, NM 87109-2155

Phone

(505) 955-9454

Fax

(505) 888-9644

NPI assigned

Feb 9, 2007

Sex

Male

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 AZ, NM2 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

Family Practice

Education

University of New Mexico School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Care CenterGroup PAC ID 8921043035, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.lopez.1@19212.direct.athenahealth.com

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.

• Southwest Care Center

  • Federally Qualified Health Center (FQHC)
  • Santa Fe, NM
  • NPI 1871602698
  Medicare reassignment Care Compare group NPD
• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• Southwest Care Center

  • Federally Qualified Health Center (FQHC)
  • Santa Fe, NM
  • NPI 1295109072
  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Phoenix, AZ
  • NPI 1992038004
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162

  Family Medicine

  NPD (past)

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

• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1356482426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6880",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875026880",
            "telephone_number": "505-216-0332",
            "fax_number": "505-982-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092155",
            "telephone_number": "505-955-9454",
            "fax_number": "505-888-9644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "649 Harkle Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875054765",
            "country_code": "US",
            "telephone_number": "505-955-9454",
            "fax_number": "505-216-9067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "KEVIN",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "36573",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2020-0934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51507307",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julian Manuel Lopez
• Juliet M Lopez, MD
• Kaila Lopez
• Kathleen Marie Lopez, MD
• Kelly Laurel Lopez, CRNA
• Kristy Depree Lopez
• Lanier Lopez, M.D.
• Leandro Maurice Lopez, OTR/L
• Lisa Paulette Lopez, M.S., LMHC
• Lizbeth Lopez

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.