Active NPI
Ivy Grace Lopez, OTR/L
- Specialist
- Jamaica, NY
National Provider Identifier
1538568894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 018985
- Practice address
- 8829 180TH St FL 2
Jamaica, NY 11432-4737 - Phone
- (914) 426-9779
- Fax
- (718) 880-1240
- NPI assigned
- Aug 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 018985 | NY | Primary |
Addresses
Primary practice location
8829 180TH St FL 2
Jamaica, NY 11432-4737
Mailing address
8829 180TH St FL 2
Jamaica, NY 11432-4737
Phone (914) 426-9779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018985 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408665600000",
"number": "1538568894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8829 180TH ST FL 2",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114324737",
"telephone_number": "914-426-9779",
"fax_number": "718-880-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8829 180TH ST FL 2",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114324737",
"telephone_number": "914-426-9779",
"fax_number": "718-880-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "IVY GRACE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-22",
"last_updated": "2014-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "018985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.