Active NPI
Candice Lopez, PA
- Physician Assistant
- New York, NY
National Provider Identifier
1447879275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 025846
- Practice address
- 211 E 51St St
New York, NY 10022-6526 - Phone
- (212) 906-7798
- NPI assigned
- Apr 12, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 025846 | NY | Primary |
Addresses
Primary practice location
211 E 51St St
New York, NY 10022-6526
Mailing address
211 E 51St St
New York, NY 10022-6526
Phone (212) 906-7798
Other practice location 1
570 Lexington Ave Fl 9
New York, NY 10022-6710
Phone (646) 962-7277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220302002770 | NY | Order and Referring Only - Physician Assistant | 1052705357 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- clopez1232893@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1447879275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 E 51ST ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100226526",
"telephone_number": "212-906-7798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 E 51ST ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100226526",
"telephone_number": "212-906-7798"
}
],
"practiceLocations": [
{
"address_1": "570 Lexington Ave Fl 9",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100226710",
"country_code": "US",
"telephone_number": "646-962-7277",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOPEZ",
"first_name": "CANDICE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-12",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "025846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.