Individual provider Active NPI

Jairo Eduardo Lopez, M.D.

  • Family Medicine Physician
  • Hemet, CA
National Provider Identifier
1669666186
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A96832 Issued in CA
Practice address
880 N State St
Hemet, CA 92543
Phone
(951) 766-2450
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A96832 CA Primary

Addresses

Primary practice location

880 N State St
Hemet, CA 92543

Mailing address

880 N State St
Hemet, CA 92543-1459
Phone (951) 766-2450

Other practice location 1

880 N State St
Hemet, CA 92543
Phone (951) 766-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101013000436 CA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 4385836048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

880 N State St
Hemet, CA 92543-1459
Phone (951) 766-2450

Hospital & facility affiliations

  • Newline Home Health and Palliative Care, Inc. Home health agency, Colton, CA, CCN 559266
  • Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292
  • San Gorgonio Memorial Hospital Hospital, Banning, CA, CCN 050054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96832CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Springs Medical Group, Inc. Family Medicine CurrentSince Jan 12, 2019 Accepting new patients
County of Riverside CurrentSince Sep 11, 2015 Accepting new patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Sep 11, 2015 Accepting new patients
Reuben C Castillo, Professional Corporation Past Accepting new patients

Locations

880 N State St
Hemet, CA 92543
Phone (951) 766-2450

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

4065 County Circle Dr
Ste 403
Riverside, CA 92503

Interoperability endpoints

  • Direct secure messaging: jlopez96832@direct.llu.edu

Organizations & group practices 5

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 3

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1669666186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 N STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925431459",
            "telephone_number": "951-766-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 N STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "951-766-2450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 N State St",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "92543",
            "country_code": "US",
            "telephone_number": "951-766-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JAIRO",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A96832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.