Individual provider Active NPI

Cassandra Evelyn Lopez, MD

  • Family Medicine Physician
  • Lewistown, MT
National Provider Identifier
1669859971
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MED-PHYS-LIC-78955 Issued in MT
Practice address
408 Wendell Ave
Lewistown, MT 59457-2261
Phone
(406) 535-1502
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 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 MED-PHYS-LIC-78955 MT Primary

Addresses

Primary practice location

408 Wendell Ave
Lewistown, MT 59457-2261

Mailing address

408 Wendell Ave
Lewistown, MT 59457-2261
Phone (406) 535-1502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20231227002446 UT Practitioner - Family Practice 4981935590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Regional Hospitalists LLCGroup PAC ID 4789807165, 119 clinicians

Practice addresses (Care Compare)

11925 S State St
Draper, UT 84020-7735
Phone (801) 783-5011

Hospital & facility affiliations

  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
  • Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017
  • Ogden Regional Medical Center Inpatient rehabilitation facility, Ogden, UT, CCN 46T005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-78955MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santibanez Pac Utah CurrentSince Dec 5, 2024 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Nov 12, 2023 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Nov 12, 2023 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

11925 S State St
Draper, UT 84020
Phone (801) 545-8000

5505 S 900 E
Ste 240
Murray, UT 84117
Phone (801) 406-9601

1992 S Columbia Ln
Orem, UT 84097
Phone (801) 724-6500

451 E Bishop Federal Ln
South Salt Lake, UT 84115
Phone (801) 487-7557

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Organizations & group practices 3

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1669859971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 WENDELL AVE",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594572261",
            "telephone_number": "406-535-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 WENDELL AVE",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594572261",
            "telephone_number": "406-535-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CASSANDRA",
        "middle_name": "EVELYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-78955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, MT

Sources for this page

Verify at the official NPI Registry.