Individual provider Active NPI

Patrick Lopez, FNP-C

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1649876889
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
250780 Issued in AZ
Practice address
3420 S Mercy Rd Ste 101
Gilbert, AZ 85297-0420
Phone
(480) 899-4420
Fax
(480) 219-3214
NPI assigned
Dec 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 250780 AZ Primary

Addresses

Primary practice location

3420 S Mercy Rd Ste 101
Gilbert, AZ 85297-0420

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210909002580 AZ Practitioner - Nurse Practitioner 0749686194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3420 S Mercy Rd
Suite 101
Gilbert, AZ 85297-0420
Phone (702) 480-2550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
250780AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
4C Medical Group PLC CurrentSince Sep 24, 2021 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Oct 18, 2023 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Oct 18, 2023 Accepting new patients
4C Medical Group PLC CurrentSince Sep 24, 2021 Accepting new patients

Locations

3420 S Mercy Rd
Ste 101
Gilbert, AZ 85297
Phone (480) 821-3800

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

9590 E Ironwood Square Dr
Ste 125
Scottsdale, AZ 85258
Phone (480) 272-6400

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

Interoperability endpoints

  • Direct secure messaging: plopez114012@westdirect.optum.com

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.

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1649876889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203",
            "fax_number": "702-838-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 S MERCY RD STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970420",
            "telephone_number": "480-899-4420",
            "fax_number": "480-219-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "PATRICK",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "250780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.