Individual provider Active NPI

Joseph I Lopez, MD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Glen Cove, NY
National Provider Identifier
1609947878
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
146448 Issued in NY
Practice address
86 Forest Ave Ste 1-C
Glen Cove, NY 11542-2194
Phone
(516) 671-4110
Fax
(517) 759-4069
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 146448 NY Primary

Addresses

Primary practice location

86 Forest Ave Ste 1-C
Glen Cove, NY 11542-2194

Mailing address

86 Forest Ave Ste 1-C
Glen Cove, NY 11542-2194
Phone (516) 671-4110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120329000084 NY Practitioner - Orthopedic Surgery 2163682154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Medical PLZ
Glen Cove, NY 11542-2170

86 Forest Ave
Suite 1 C
Glen Cove, NY 11542-2194
Phone (516) 671-4110

Hospital & facility affiliations

  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph I. Lopez, M.D., P.C. CurrentSince Jul 1, 1989 Accepting new patients

Locations

86 Forest Ave
Ste 1C
Glen Cove, NY 11542
Phone (516) 671-4110

10 Medical Plz
Ste 103
Glen Cove, NY 11542
Phone (516) 671-4110

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1609947878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 FOREST AVE STE 1-C",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422194",
            "telephone_number": "516-671-4110",
            "fax_number": "517-759-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 FOREST AVE STE 1-C",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422194",
            "telephone_number": "516-671-4110",
            "fax_number": "517-759-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSEPH",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NY",
            "license": "146448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.