Individual provider Active NPI

Jose R. Lopez, MD,FAAP

  • Pediatrics Physician
  • Freehold, NJ
National Provider Identifier
1649294182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA02343600 Issued in NJ
Practice address
470 Stillwells Corner Rd
Freehold, NJ 07728-2969
Phone
(732) 780-3333
Fax
(732) 780-6968
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA02343600 NJ Primary

Addresses

Primary practice location

470 Stillwells Corner Rd
Freehold, NJ 07728-2969

Mailing address

470 Stillwells Corner Rd
Freehold, NJ 07728-2969
Phone (732) 780-3333

Other identifiers 1

IdentifierTypeStateIssuer
4685601MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA02343600NJMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649294182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 STILLWELLS CORNER RD",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282969",
            "telephone_number": "732-780-3333",
            "fax_number": "732-780-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 STILLWELLS CORNER RD",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282969",
            "telephone_number": "732-780-3333",
            "fax_number": "732-780-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSE",
        "middle_name": "R.",
        "credential": "MD,FAAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA02343600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4685601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.