Individual provider Active NPI

Salvador Lopez, PA-C

  • Medical Physician Assistant
  • Yakima, WA
National Provider Identifier
1649726852
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
OA60743170 Issued in WA
Practice address
310 Holton Ave
Yakima, WA 98902-3208
Phone
(509) 452-2508
Fax
(509) 452-7316
NPI assigned
Aug 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X OA60743170 WA Primary

Addresses

Primary practice location

310 Holton Ave
Yakima, WA 98902-3208

Mailing address

80 Hoyt Lane
Wapato, WA 98951-9753
Phone (509) 388-3388

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170105000959 WA Practitioner - Physician Assistant 9638450695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Medical Clinic Inc PCGroup PAC ID 8224920996, 3 clinicians

Practice addresses (Care Compare)

310 Holton Ave
Yakima, WA 98902-3208
Phone (509) 452-2508

Hospital & facility affiliations

  • Mountainview Home Health Home health agency, Yakima, WA, CCN 507115
  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnicale Pain Center Medical Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sallopezpac@direct.meditouchehr.com

Organizations & group practices 2

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1649726852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HOYT LANE",
            "city": "WAPATO",
            "state": "WA",
            "postal_code": "989519753",
            "telephone_number": "509-388-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HOLTON AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023208",
            "telephone_number": "509-452-2508",
            "fax_number": "509-452-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "SALVADOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "OA60743170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.