Individual provider Active NPI

Jose R Lopez, M.D.

  • Internal Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1568667228
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A43301 Issued in CA
Practice address
1660 Broadway
Suite 10
Chula Vista, CA 91911-4856
Phone
(619) 498-3755
NPI assigned
Jun 20, 2007
Last updated
May 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A43301 CA Primary

Addresses

Primary practice location

1660 Broadway
Suite 10
Chula Vista, CA 91911-4856

Mailing address

2648 Main St
Ste a
Chula Vista, CA 91911-4664
Phone (619) 498-3755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050524001361 CA Practitioner - Internal Medicine 9436191095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2648 Main St
Suite a
Chula Vista, CA 91911-4664
Phone (619) 575-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44301CAMDDentist
A43301CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Care, a Medical Corporation Internal Medicine CurrentSince Jun 11, 2002 Accepting new patients
Scripps Health Current Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Maroon-Lopez DDS, PC PastSince Jun 11, 2002 Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Paradise Valley Hospital Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

1660 Broadway
Ste 10
Chula Vista, CA 91911
Phone (619) 498-3755

2648 Main St
Ste A
Chula Vista, CA 91911
Phone (619) 423-5200

4184 Beyer Blvd
Ste 105
San Ysidro, CA 92173

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jlopez179561@scrippshlth.medalliesdirect.net
  • Direct secure messaging: jlopez34103@sharphealthcare.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495584000000",
    "number": "1568667228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2648 MAIN ST",
            "address_2": "STE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919114664",
            "telephone_number": "619-498-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 BROADWAY",
            "address_2": "SUITE 10",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919114856",
            "telephone_number": "619-498-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2017-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A43301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.