Individual provider Active NPI

Joel Osvaldo Lopez, M.D.

  • General Practice Physician
  • Las Marias, PR
National Provider Identifier
1376762179
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16683 Issued in PR
Practice address
31 Calle San Benito
Las Marias, PR 00670-2103
Phone
(787) 827-0285
Fax
(787) 827-0285
NPI assigned
Apr 24, 2007
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16683 PR Primary

Addresses

Primary practice location

31 Calle San Benito
Las Marias, PR 00670-2103

Mailing address

PO Box 3123
Mayaguez, PR 00681-3123
Phone (787) 428-8228

Other practice location 1

3 Providencia Barrero
Urb Los Alamos
San Sebastian, PR 00685
Phone (787) 896-1189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070813000449 PR Practitioner - General Practice 4082705546 Reassigns benefits to 1 organization
Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Clinical Group PSCGroup PAC ID 2365665106, 2 clinicians

Practice addresses (Care Compare)

31 Calle San Benito
Las Marias, PR 00670-2103
Phone (787) 827-0285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16683PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Clinical Group PSC General Practice CurrentSince Apr 12, 2014 Accepting new patients
Wellness Clinical Services, LLC PastSince Oct 1, 2023 Accepting new patients

Locations

3 Calle Providencia Barrero
San Sebastian, PR 00685
Phone (787) 896-1189

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1376762179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006813123",
            "telephone_number": "787-428-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 CALLE SAN BENITO",
            "city": "LAS MARIAS",
            "state": "PR",
            "postal_code": "006702103",
            "telephone_number": "787-827-0285",
            "fax_number": "787-827-0285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Providencia Barrero",
            "address_2": "Urb Los Alamos",
            "address_purpose": "LOCATION",
            "city": "San Sebastian",
            "state": "PR",
            "postal_code": "00685",
            "country_code": "US",
            "telephone_number": "787-896-1189",
            "fax_number": "787-280-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOEL",
        "middle_name": "OSVALDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Marias, PR

Sources for this page

Verify at the official NPI Registry.