NPIMap

Individual provider Active NPI

Albert Arthur Lopez Jr., D.O.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1730130857
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS0007397 Issued in FL
Practice address
4291 Roosevelt Blvd
Jacksonville, FL 32210-2061
Phone
(904) 598-1888
Fax
(904) 384-4928
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS0007397 FL Primary

Addresses

Primary practice location

4291 Roosevelt Blvd
Jacksonville, FL 32210-2061

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
57573BOtherFLMEDICARE LEGACY NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000167 FL Practitioner - Internal Medicine 3678747334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Nova Southeastern College of Osteo Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

4291 Roosevelt Blvd
Jacksonville, FL 32210-2061
Phone (904) 598-1888

Hospital & facility affiliations

  • Community Hospice of Northeast Florida Inc Hospice, Jacksonville, FL, CCN 101500
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0007397FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Internal Medicine CurrentSince May 17, 2021 Accepting new patients
Millennium Physician Group LLC CurrentSince May 17, 2021 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

4291 Roosevelt Blvd
Ste 204
Jacksonville, FL 32210

4291 Roosevelt Blvd
Jacksonville, FL 32210
Phone (904) 598-1888

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: albert.lopez.1@4290.direct.athenahealth.com
  • Direct secure messaging: alopez@lima.gwaydirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1730130857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4291 ROOSEVELT BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102061",
            "telephone_number": "904-598-1888",
            "fax_number": "904-384-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ALBERT",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS0007397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY NUMBER",
            "identifier": "57573B",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.