Individual provider Active NPI

Enrique Lopez Guimera, MD

  • Internal Medicine Physician
  • Manitowoc, WI
National Provider Identifier
1750027702
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
84621-20 Issued in WI
Practice address
Froedtert Holy Family Memorial Hospital
2300 Western Ave
Manitowoc, WI 54220-3712
Phone
(920) 320-2012
NPI assigned
May 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME169424 FL
Internal Medicine Physician 207R00000X 84621-20 WI Primary

Addresses

Primary practice location

Froedtert Holy Family Memorial Hospital
2300 Western Ave
Manitowoc, WI 54220-3712

Mailing address

2300 Western Ave
Manitowoc, WI 54220-3712
Phone (305) 284-7761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240813001476 FL Practitioner - Internal Medicine 8123566817 Reassigns benefits to 2 organizations
I20250516000916 WI Practitioner - Internal Medicine 8123566817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

1414 N Taylor Dr
Sheboygan, WI 53081-1988
Phone (920) 320-2436

2300 Western Ave
Manitowoc, WI 54220-3712
Phone (920) 320-2011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84621-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert Manitowoc Medical Group, LLC Internal Medicine CurrentSince Mar 10, 2025 Accepting new patients
Nova Hospitalist Group LLC Internal Medicine CurrentSince Jul 2, 2024 Accepting new patients
Nova Medical Services LLC Internal Medicine CurrentSince Jul 2, 2024 Accepting new patients

Locations

8260 W Flagler St
Ste 2I
West Miami, FL 33144
Phone (786) 530-6272

2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011

1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011

Interoperability endpoints

  • Direct secure messaging: elopezguimera835907@direct.froedtert.com

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": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1750027702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WESTERN AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203712",
            "telephone_number": "305-284-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL",
            "address_2": "2300 WESTERN AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203712",
            "telephone_number": "920-320-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ GUIMERA",
        "first_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME169424",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "84621-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.