Edwin C Lopez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10000864 Issued in WA

Practice address

1455 Battersby Ave
Enumclaw, WA 98022-3634

Phone

(253) 426-6341

Fax

(253) 426-6344

NPI assigned

Oct 2, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physician Assistant

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lourdes Hospital LLCGroup PAC ID 1850642562, 42 clinicians

Grant County Public Hospital District No. 3Group PAC ID 6709775166, 68 clinicians

Grant County Public Hospital District No. 3Group PAC ID 8325937675, shared by 2 NPIs, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Othello Community Hospital Hospital, Othello, WA, CCN 501318
• Columbia Basin Hospital Hospital, Ephrata, WA, CCN 501317

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Lourdes Hospital LLC

  • Internal Medicine Physician
  • Pasco, WA
  • NPI 1659861060
  Medicare reassignment Care Compare group NPD
• Grant County Public Hospital District 3

  dba Columbia Basin Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Ephrata, WA
  • NPI 1134283930
  Medicare reassignment Care Compare group
• Adams County Public Hospital District 3

  dba Othello Community Hospital

  • Critical Access Hospital
  • Othello, WA
  • NPI 1811108822
  Medicare reassignment NPD
• R & B Fleck Enterprises, LLC

  • General Practice Physician
  • Richland, WA
  • NPI 1225163926
  Medicare reassignment
• Franciscan Medical Group

  dba FMG - Franciscan Neurology - Federal Way

  • Neurological Surgery Physician
  • Federal Way, WA
  • NPI 1386857530
  NPD (past)
• Lourdes Hospital LLC

  dba Lourdes Counseling Center

  • Psychiatric Hospital
  • Richland, WA
  • NPI 1548342181
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adams County Public Hospital District 3

  dba Othello Community Hospital

  • Critical Access Hospital
  • Othello, WA
  • NPI 1811108822
  Care Compare affiliation
• Grant County Public Hospital District No. 3

  dba Columbia Basin Hospital

  • Critical Access Hospital
  • Ephrata, WA
  • NPI 1811979610
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1649363706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 BATTERSBY AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223634",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "EDWIN",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10000864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0127911",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1045085",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "970007234",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CRIME VICTIMS",
            "identifier": "8902557",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yongqing Li, MD
• Devin Kay Lindstrom, DMD
• Living Court Ventures, L.L.C.
• Grant Shih Ming Lo, DDS
• Anna Joan Lockard, MA LMHC
• Susan D. Louie, OTR L
• Carly Catherine Love, SLP-CFY
• Amanda L. Lugo, PAC
• George R Magley, MD
• Joseph Magley, MD

• Physician Assistant in Enumclaw, WA
• Providers in Enumclaw, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.