Active NPI
Juan S Lopez, MD
- Gynecology Physician
- New York, NY
National Provider Identifier
1801974241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- A109431-1
- Practice address
- 64 Nagle Ave FL 2
New York, NY 10040-1406 - Phone
- (646) 344-1715
- Fax
- (917) 997-9555
- NPI assigned
- Nov 2, 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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | A109431-1 | NY | Primary |
Addresses
Primary practice location
64 Nagle Ave FL 2
New York, NY 10040-1406
Mailing address
19 Sageman Street
Mount Vernon, NY 10550
Phone (914) 699-0989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A109431-1 | NY | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brooklyn Medical Associate, LFPC | Past | Accepting new patients | |
| Hunts Point Multi Service Ctr Inc | Past | Accepting new patients |
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.
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- Internal Medicine Physician
- Brooklyn, NY
- NPI 1851685846
-
- Ph.D. Medical Genetics
- Bronx, NY
- NPI 1740359025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1801974241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 SAGEMAN STREET",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-699-0989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 NAGLE AVE FL 2",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100401406",
"telephone_number": "646-344-1715",
"fax_number": "917-997-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JUAN",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NY",
"license": "A109431-1",
"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 Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.