Agustin Lopez-Marrero, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13386 Issued in PR

Practice address

1511 Ave Ponce de Leon Ste 3
San Juan, PR 00909-5001

Phone

(787) 339-2639

NPI assigned

Jul 13, 2005

Last updated

Feb 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Agustin Lopez Other name

Medicare fee-for-service enrollment

Enrolled in PR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: agustin.lopez-marrero@54618109378564.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salud Integral En la Montana, Inc

  • Federally Qualified Health Center (FQHC)
  • Corozal, PR
  • NPI 1184647851

  Single Specialty

  Medicare reassignment NPD
• Salud Integral En la Montana, Inc

  • Federally Qualified Health Center (FQHC)
  • Naranjito, PR
  • NPI 1578586244

  Single Specialty

  Medicare reassignment NPD
• Pravan Wellness, LLC

  • Clinic/Center
  • San Juan, PR
  • NPI 1780227504
  NPD
• Salud Integral En la Montana, Inc

  • Mammography Clinic/Center
  • Corozal, PR
  • NPI 1013498583

  Single Specialty

  NPD
• Salud Integral En la Montana, Inc.

  • Radiology Clinic/Center
  • Bayamon, PR
  • NPI 1306327341

  Single Specialty

  NPD

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1801894787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PINERO AVENUE",
            "address_2": "SUITE 1701",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184178",
            "telephone_number": "787-309-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 AVE PONCE DE LEON STE 3",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009095001",
            "telephone_number": "787-339-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-MARRERO",
        "first_name": "AGUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "13386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGUSTIN",
            "last_name": "LOPEZ",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Josefina M. Lopez-Garcia, M.D.
• Francisco Manuel Lopez-Gonzalez, M.D.
• Vicente Lopez-Hidalgo, MD
• Kennice M Lopez-Irizarry, M.D.
• Julio Cesar Lopez-Maldonado, MD
• Nayda T Lopez-Morales, M.D.
• Lourdes Esther Lopez-Nieves
• Karolyne Li Lopez-Otero, PHARMD
• Jose Carlos Lopez-Puebla
• Maria Lopez-Quintero, M.D.

• Family Medicine Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Family Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.

Verify at the official NPI Registry.