Individual provider Active NPI

Simon Yaguare Lopez, MD

  • Surgery Physician
  • Albuquerque, NM
National Provider Identifier
1669000808
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2026-03388 Issued in NC
Practice address
1 University of New Mexico Msc10 5530
Albuquerque, NM 87131-0001
Phone
(505) 272-4161
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD2025-0390 NM
Surgery Physician 208600000X 2026-03388 NC Primary

Addresses

Primary practice location

1 University of New Mexico Msc10 5530
Albuquerque, NM 87131-0001

Mailing address

1 University of New Mexico Msc10 5530
Albuquerque, NM 87131-0001

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 323-2626

Other practice location 2

1841 Quiet Cv
Fayetteville, NC 28304-3985
Phone (910) 323-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20250806001542 NM Order and Referring Only - General SurgeryPractitioner - General Surgery 6204344526

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 40908
Fayetteville, NC 28309

PO Box
Suite 40908
Fayetteville, NC 28309-0908

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2025-0390NMMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1669000808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO MSC10 5530",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO MSC10 5530",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-4161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-323-2626",
            "fax_number": "910-484-7962",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1841 Quiet Cv",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043985",
            "country_code": "US",
            "telephone_number": "910-323-2626",
            "fax_number": "910-484-7962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAGUARE LOPEZ",
        "first_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "MD2025-0390",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2026-03388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.