Marisa P Lopez, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME90785 Issued in FL

Practice address

1330 SE 4TH Ave Ste J
Fort Lauderdale, FL 33316

Phone

(954) 620-3307

NPI assigned

May 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Marisa Prego Lopez Professional name

Medicare fee-for-service enrollment

Enrolled in FL, NM, MA, RI, VT, ME, NH, OH, GA, TN, MO, MI, VA, NY14 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 14

Specialty

Neurology

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpregolopez@direct.carene.org
• FHIR API: https://api.platform.athenahealth.com/13023/brand/4/csg/1/fhir/r4

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.

• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  FL, GA, MA, ME, MI, MO, Neurology, NH, NM, NY, OH, RI, TN, VA, VT

  Medicare reassignment Care Compare group NPD
• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662

  Neurology

  NPD
• Sunrise Medical Group I, LLC

  • Neurology Physician
  • Hollywood, FL
  • NPI 1902185143
  NPD (past)
• Sunrise Medical Group Inc

  • Neurology Physician
  • Hollywood, FL
  • NPI 1912957697
  NPD (past)
• Department of Neurology Professional Services Group/Slrhc

  • Neurology Physician
  • New York, NY
  • NPI 1811974330
  NPD (past)
• Truman Medical Centers, Inc.

  • Home Health Agency
  • Kansas City, MO
  • NPI 1487797759
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1770538605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9960 NW 116TH WAY STE 13",
            "city": "MEDLEY",
            "state": "FL",
            "postal_code": "331781175",
            "telephone_number": "786-924-1311",
            "fax_number": "786-924-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SE 4TH AVE STE J",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-620-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARISA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME90785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269970200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "PREGO LOPEZ",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hassel Yesenia Lopez
• Isabella Mellits Lopez, MD
• Jacqueline Lopez
• Johanna Lopez, RDN
• Louise Raphaela Lopez, PSY.D.
• Miguel Lopez, PA
• Rogelio Lopez, RPH
• Frank John Lopresti Jr.
• Viviana Lorda Seijo, M.D
• Anabel Lorente

• Neurology Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.