Individual provider Active NPI

Nicholas Lopez, MD

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1649662073
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD219244 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 418-5700
Fax
(503) 418-5704
NPI assigned
Feb 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ML60864368 WA
Child Abuse Pediatrics Physician 2080C0008X MD219244 OR
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD219244 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 418-5700

Other practice location 1

4800 Sand Point Way NE, OC.7.830
Seattle, WA 98105
Phone (206) 987-2345

Other practice location 2

25 E Delaware Pl
Apt 401
Chicago, IL 60611-1828
Phone (703) 581-3088

Other practice location 3

25 E Delaware Pl
Apt 401
Chicago, IL 60611-1828
Phone (703) 581-3088

Other practice location 4

4800 Sand Point Way NE # Oc.7830
Seattle, WA 98105-3901
Phone (206) 987-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240720000513 OR Practitioner - Pediatric Medicine 6709133978 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML60864368WAMDPediatrics Physician
MD219244ORMDChild Abuse Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jul 8, 2024 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jul 8, 2024 Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2800 N Vancouver Ave
Ste 201
Portland, OR 97227
Phone (503) 276-9000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1649662073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5700",
            "fax_number": "503-418-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5700",
            "fax_number": "503-418-5704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE, OC.7.830",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98105",
            "country_code": "US",
            "telephone_number": "206-987-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 E Delaware Pl",
            "address_2": "Apt 401",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606111828",
            "country_code": "US",
            "telephone_number": "703-581-3088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 E Delaware Pl",
            "address_2": "Apt 401",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606111828",
            "country_code": "US",
            "telephone_number": "703-581-3088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4800 Sand Point Way NE # Oc.7830",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML60864368",
            "primary": false
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "OR",
            "license": "MD219244",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD219244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.