Elisa M. Montross-Lopez, MD..
Individual provider Active NPI Family Medicine Physician · Milton, DE
NPI 1376536623 · NPPES record last updated Oct 12, 2012
Key facts
- NPI
- 1376536623
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- C1-0004991 (DE)
- Practice address
- 630 Mulberry Street
Milton, DE 19968 - Phone
- (302) 684-8053
- Fax
- (302) 684-8059
- NPI assigned
- Aug 23, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Perelman School of Med at the University of Pennsylvania, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Beebe Physician Network Inc.
Practice addresses (Care Compare)
19161 Healthy Way
Rehoboth Beach, DE 19971-4491
Phone (302) 645-3300
21635 Biden Ave
Georgetown, DE 19947-4574
Phone (302) 260-7360
21635 Biden Ave
Unit 101
Georgetown, DE 19947-4575
Phone (302) 645-3555
28538 Dupont Blvd
Millsboro, DE 19966-4791
Phone (302) 934-0944
32550 Docs PL
Unit 2
Millville, DE 19967-6975
Phone (302) 539-4302
32556 Docs PL
Millville, DE 19967-6953
Phone (302) 645-9325
Hospital & facility affiliations
- Beebe Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 80 of 100
- Quality
- 62.88
- Promoting interoperability
- 94
- Improvement activities
- 40
- Cost
- 75.47
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090304000782 | DE | Practitioner - Family Practice | 4789740408 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0004991 | DE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beebe Physician Network Inc. | Current |
Accepting new patients |
Locations
640 S State St
#742
Dover, DE 19901
640 S State St
Dover, DE 19901
Phone (302) 744-4700
1515 Savannah Rd
Lewes, DE 19958
1305 Savannah Rd
Lewes, DE 19958
Phone (302) 291-6450
1305 Savannah Rd
Ste 1
Lewes, DE 19958
Phone (302) 645-2281
32550 Docs Pl
Unit 2
Millville, DE 19967
Phone (302) 539-4302
Interoperability endpoints
- elopez22797@beebehealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C1-0004991 | DE | Yes |
Addresses
Primary practice location
630 Mulberry Street
Milton, DE 19968
Mailing address
640 S State St
742 Building
Dover, DE 19901-3530
Phone (302) 674-3970
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002 | Other | DE | CAREFIRST BCBS DC |
| 0000821101 | Medicaid | DE | |
| 5728537 | Other | DE | AETNA |
| 080107124 | Other | DE | RAILROAD MEDICARE |
| 0420453000 | Other | DE | AMERIHEALTH |
| 60953701 | Other | DE | CAREFIRST BCBS |
| 15RG73 | Other | DE | BLUE CROSS BLUE SHIELD DE |
| 47279 | Other | DE | PRINCIPAL HEALTHCARE |
| 248021 | Other | DE | MAMSI/UNITED HEALTH CARE |
Other providers in Milton, DE
- Millsboro Eye Care LLC
- Scott Milstein
- Milton Chiropractic, LLC
- Milton Fire Department Inc
- Milton Pharmacy,Inc.
- Jimmy Moon
- Nicole E. Moore
- Tracy Michelle Moran
- Melvin L Morse
- Karen Neuwirth
All providers in Milton, DE · Family Medicine Physician in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.