Jose A. Lopez Gonzalez, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

17667 Issued in AZ

Practice address

1810 S Crismon Rd
Suite 191
Mesa, AZ 85209-3717

Phone

(480) 393-0575

Fax

(480) 704-4019

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19475/brand/10/csg/41/fhir/r4
• Direct secure messaging: jose.lopez.1@19475.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.

• Bourbon Physician Practice LLC

  • Family Medicine Physician
  • Paris, KY
  • NPI 1790195717
  Medicare reassignment NPD
• Reddy Gi Associates

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1508399544
  NPD
• Bourbon Physician Practice LLC

  • Rural Health Clinic/Center
  • Carlisle, KY
  • NPI 1356689079
  NPD
• Bourbon Physician Practice LLC

  • Rural Health Clinic/Center
  • Paris, KY
  • NPI 1962111716
  NPD
• Banner Sun City Medical Group

  • Multi-Specialty Clinic/Center
  • Sun City, AZ
  • NPI 1902067200
  NPD (past)
• Central Arizona Gi & Liver Institute LLC

  • Ambulatory Surgical Clinic/Center
  • Gilbert, AZ
  • NPI 1164871075
  NPD (past)
• Clinical Associates in Internal Medicine, LTD

  • Specialist
  • Phoenix, AZ
  • NPI 1073794566
  NPD (past)
• Sun Health Corporation

  • Clinic/Center
  • Sun City, AZ
  • NPI 1568412658
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1396701694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064709",
            "telephone_number": "480-393-0575",
            "fax_number": "480-704-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 S CRISMON RD",
            "address_2": "SUITE 191",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093717",
            "telephone_number": "480-393-0575",
            "fax_number": "480-704-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ GONZALEZ",
        "first_name": "JOSE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "17667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "867856",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine S Looby, PA-C
• Hilda Lood
• James Robert Lopenowski, MS, BCBA, LBA
• Makayla Nicole Loper, AZ-LDO, ABO-C, NCLEC
• Yarelis Lopez Alvarez, BCBA
• Raul A. Lopez Gonzalez, M.D.
• Julianne Lopez Haddad, LCSW
• Juan Pablo Lopez Rios
• Esther Lopez-Moryl, LCSW
• Charissa Anyel Lopez, PMHNP

• Surgery Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.