Maritza Lopez, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36354 Issued in MN

Practice address

112 Saint Olaf Ave S
Canby, MN 56220-1433

Phone

(507) 223-7277

Fax

(507) 223-7465

NPI assigned

Aug 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Sanford Health Network

  • Critical Access Hospital
  • Canby, MN
  • NPI 1780781054

  MN

  Medicare reassignment NPD
• Sanford Health Network

  • Family Medicine Physician
  • Tracy, MN
  • NPI 1699869875

  Internal Medicine

  NPD

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1598777948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SAINT OLAF AVE S",
            "city": "CANBY",
            "state": "MN",
            "postal_code": "562201433",
            "telephone_number": "507-223-7277",
            "fax_number": "507-223-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SAINT OLAF AVE S",
            "city": "CANBY",
            "state": "MN",
            "postal_code": "562201433",
            "telephone_number": "507-223-7277",
            "fax_number": "507-223-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARITZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "36354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053823000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlopez8051@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "112 Saint Olaf Ave S",
            "city": "Canby",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562201433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adam Lee Hoffmann, PT, DPT, ITPT
• Jennifer Jackson, P.T.
• Jorzach Inc
• Craig Roy Kaddatz, DC
• Melissa Konold, PT
• Katherine Joan Mackenzie, FNP-BC
• Casey M Meier
• Peter Brennan Meier, M.D.
• Miranda Jo Ristau Obaniana, DPT
• Mari Petersen, OTR/L

• All providers in Canby, MN
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.