Individual provider Active NPI

Melissa Caryn Lopez, NP

  • Family Nurse Practitioner
  • Janesville, WI
National Provider Identifier
1497397707
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1060933 Issued in WI
Practice address
700 Myrtle Way
Janesville, WI 53545-9111
Phone
(815) 608-4673
NPI assigned
Oct 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 041355297 IL
Family Nurse Practitioner 363LF0000X 1060933 WI Primary

Addresses

Primary practice location

700 Myrtle Way
Janesville, WI 53545-9111

Mailing address

700 Myrtle Way
Janesville, WI 53545-9111
Phone (815) 608-4673

Other identifiers 1

IdentifierTypeStateIssuer
1235125717OtherILGRP NPI

Other names 1

  • Melissa C Levin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191018001692 IL Practitioner - Nurse Practitioner 3971834102 Reassigns benefits to 4 organizations
I20210614001181 WI Practitioner - Nurse Practitioner 3971834102 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041355297ILMDFamily Nurse Practitioner
1060933WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care Navigators Inc. CurrentSince Jun 1, 2020 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Sep 30, 2024 Accepting new patients
In Home Medical Group LLC Family CurrentSince Feb 7, 2024 Accepting new patients

Locations

321 Jefferson St
Algonquin, IL 60102
Phone (847) 250-1829

471 W Terra Cotta Ave
Crystal Lake, IL 60014
Phone (815) 455-0550

335 Illinois St
Crystal Lake, IL 60014
Phone (815) 459-7791

4215 Newburg Rd
Rockford, IL 61108
Phone (815) 988-8500

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

1505 Orrin Rd
Prescott, WI 54021
Phone (715) 262-1107

Interoperability endpoints

  • Direct secure messaging: melissa.lopez.p1@direct.alegiscare.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1497397707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MYRTLE WAY",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535459111",
            "telephone_number": "815-608-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MYRTLE WAY",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535459111",
            "telephone_number": "815-608-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MELISSA",
        "middle_name": "CARYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041355297",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1060933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP NPI",
            "identifier": "1235125717",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LEVIN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.