Active NPI
Nicholas Lopez, MD
- Pediatrics Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD219244
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ML60864368 | WA | MD | Pediatrics Physician |
| MD219244 | OR | MD | Child Abuse Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | 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.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
dba Legacy Emanuel Hospital Adolescent Psychiatric Unit
- Psychiatric Hospital Unit
- Portland, OR
- NPI 1245773225
-
dba Apothecary at Emanuel Hospital
- Community/Retail Pharmacy
- Portland, OR
- NPI 1417977976
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.