Individual provider Active NPI

Jennifer Lopez, FNP-C

  • Family Nurse Practitioner
  • Farmington, NM
National Provider Identifier
1649052143
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
76370 Issued in NM
Practice address
407 S Schwartz Ave Ste 101
Farmington, NM 87401-5925
Phone
(505) 609-6595
Fax
(505) 599-4633
NPI assigned
Oct 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 76370 NM Primary

Addresses

Primary practice location

407 S Schwartz Ave Ste 101
Farmington, NM 87401-5925

Mailing address

19 Road 5251
Bloomfield, NM 87413-9720
Phone (970) 749-9227

Other practice location 1

19 Road 5251
Bloomfield, NM 87413-9720
Phone (970) 749-9227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20231128003858 NM Practitioner - Nurse Practitioner 0941657019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

407 S Schwartz Ave
101 SJR Brain and Spine
Farmington, NM 87401-5925
Phone (505) 609-6595

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. CurrentSince Dec 4, 2023 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Jan 9, 2024 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Jan 9, 2024 Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

400 Tijeras Ave NW
Ste 200
Albuquerque, NM 87102

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

407 S Schwartz Ave
Ste 101
Farmington, NM 87401
Phone (505) 609-6595

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Organizations & group practices 5

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1649052143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ROAD 5251",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "874139720",
            "telephone_number": "970-749-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S SCHWARTZ AVE STE 101",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015925",
            "telephone_number": "505-609-6595",
            "fax_number": "505-599-4633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Road 5251",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "NM",
            "postal_code": "874139720",
            "country_code": "US",
            "telephone_number": "970-749-9227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "76370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.