Organization Active NPI

Luis J Lopez MD PA

  • Gastroenterology Physician
  • Tampa, FL
National Provider Identifier
1538341789
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
LUIS J LOPEZ MD PA
Practice address
4700 N. Habana Ave
Suite 701
Tampa, FL 33614-7122
Phone
(813) 324-5888
Fax
(813) 374-8891
NPI assigned
Nov 29, 2007
Last updated
Sep 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Mr. Luis J Lopez, MDNPI 1346342201
Title
Physician
Phone
(813) 792-9752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

4700 N. Habana Ave
Suite 701
Tampa, FL 33614-7122

Mailing address

4700 N Habana Ave Ste 701
Tampa, FL 33614-7122
Phone (813) 324-5888

Other identifiers 2

IdentifierTypeStateIssuer
275993400MedicaidFL
ME93505OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080715000765 FL Part B Supplier - Clinic/Group Practice 0042383663 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2055349Luis J Lopez MD PA4700 Habana Ave Ste 701, Tampa, FL 33614Certificate of waiverMar 10, 2027

National Provider Directory

National Provider Directory

Locations

4809 N Armenia Ave
Ste 100
Tampa, FL 33603
Phone (813) 872-9310

7001 N Dale Mabry Hwy
Ste 10
Tampa, FL 33614
Phone (813) 497-9661

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1538341789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 N HABANA AVE STE 701",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147122",
            "telephone_number": "813-324-5888",
            "fax_number": "813-374-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N. HABANA AVE",
            "address_2": "SUITE 701",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147122",
            "telephone_number": "813-324-5888",
            "fax_number": "813-374-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS J LOPEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "813-792-9752",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275993400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME93505",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.