Active NPI
Johnny Lopez, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1679654347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 070236-7
- Practice address
- 57 Saint Marks PL
New York, NY 10003-7902 - Phone
- (212) 982-3470
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 070236-7 | NY | Primary |
Addresses
Primary practice location
57 Saint Marks PL
New York, NY 10003-7902
Mailing address
454 Fort Lee Rd
Leonia, NJ 07605-1115
Phone (212) 305-7694
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141022001277 | NY | Order and Referring Only - Clinical Social Worker | 4880815596 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070236-7 | NY | MD | Clinical Social Worker |
| 062882 | NY | MD | Pharmacist |
| 070236 | NY | MD | Pharmacist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679654347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "454 FORT LEE RD",
"city": "LEONIA",
"state": "NJ",
"postal_code": "076051115",
"telephone_number": "212-305-7694",
"fax_number": "212-342-5703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 SAINT MARKS PL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100037902",
"telephone_number": "212-982-3470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JOHNNY",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "070236-7",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.