Individual provider Active NPI

Wiliana E Lopez

  • Family Nurse Practitioner
  • Freeport, NY
National Provider Identifier
1669026662
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344680 Issued in NY
Practice address
301 S Main St
Freeport, NY 11520-5114
Phone
(631) 968-3360
NPI assigned
Jul 29, 2019
Last updated
Jul 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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 344680 NY Primary

Addresses

Primary practice location

301 S Main St
Freeport, NY 11520-5114

Mailing address

61 Centre St
Freeport, NY 11520-3145
Phone (516) 543-7811

Other practice location 1

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 321-8102

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL wlopez@northwell.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20191219002271 NY Practitioner - Nurse Practitioner 4789018011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 986-3308

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 14, 2020 Accepting new patients
Medical Group of New York, P.C. Family CurrentSince Dec 27, 2021 Accepting new patients

Locations

3101 Ditmars Blvd
Astoria, NY 11105
Phone (718) 545-0128

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

107 S Country Rd
Bellport, NY 11713
Phone (631) 286-2222

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

7960 Metropolitan Ave
Middle Village, NY 11379
Phone (718) 326-4910

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: wil9058@direct.nyp.org
  • Direct secure messaging: wilianalopez@nslijmedgr.allscriptsdirect.net

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, 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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1669026662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 CENTRE ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203145",
            "telephone_number": "516-543-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MAIN ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115205114",
            "telephone_number": "631-968-3360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "516-321-8102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "WILIANA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wlopez@northwell.edu",
            "affiliation": "N",
            "address_1": "61 Centre St",
            "city": "Freeport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115203145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.