Clark R. Lopez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

117032 Issued in NY

Practice address

60 Plaza St E
1-O
Brooklyn, NY 11238-5040

Phone

(718) 783-3919

Fax

(718) 398-0975

NPI assigned

Feb 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prominis Medical Services PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1841323771
  Medicare reassignment NPD
• Brooklyn Family Medical Care

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1871684753
  NPD (past) Authorized official

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619016011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HUNT LN",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110302637",
            "telephone_number": "516-627-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PLAZA ST E",
            "address_2": "1-O",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385040",
            "telephone_number": "718-783-3919",
            "fax_number": "718-398-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CLARK",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "117032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Lopez, PA
• Anthony Feliciano Lopez, MHC
• Brenda Maria Lopez
• Carmen M Lopez, RPA-C
• Catherine Lopez, MS
• Daniella Lopez, DPM
• Edgar Joel Lopez
• Edna Lopez, LMSW
• Emily Abigail Lopez
• Enna Carmen Lopez

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.