Lea Revita Lopez, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95006005 Issued in CA

Practice address

751 S Bascom Ave
Otolaryngology/Head and Neck Surgery
San Jose, CA 95128-2604

Phone

(408) 885-5000

NPI assigned

Feb 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• County of Santa Clara

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500
  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1629301346
  Medicare reassignment NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1043354020
  NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1326033929
  NPD
• County of Santa Clara

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • Gilroy, CA
  • NPI 1922093533
  NPD

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1598203408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE BLDG Q",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "OTOLARYNGOLOGY/HEAD AND NECK SURGERY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "LEA",
        "middle_name": "REVITA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006005",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95006005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith John Allen Lopez
• Laura Lopez
• Laura Lopez
• Lea Lopez
• Lea Nicole Lopez
• Lyzette Lopez
• Maria Lopez
• Maria Cassandra Lopez
• Marlenna Alcazar Lopez
• Mayra Isabel Lopez, B.A

• Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.

Verify at the official NPI Registry.