Individual provider Active NPI

Michelle Lopez Lopez, M.D

  • Adult Medicine Physician
  • Carolina, PR
National Provider Identifier
1831128420
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
15624 Issued in PR
Practice address
37-19 Calle 36
Carolina, PR 00985-5502
Phone
(787) 768-4993
Fax
(787) 768-0040
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 15624 PR Primary

Addresses

Primary practice location

37-19 Calle 36
Carolina, PR 00985-5502

Mailing address

67St 119#29
Villa Carolina
Carolina, PR 00985-5322
Phone (787) 701-0850

Other practice location 1

fernandez juncos st .edificio vanessa
B-5
carolina, PR 00985
Phone (787) 768-4993

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050627000032 PR Practitioner - General Practice 3173568524 Practice locations: Carolina, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15624PRMDAdult Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831128420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67ST 119#29",
            "address_2": "VILLA CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855322",
            "telephone_number": "787-701-0850",
            "fax_number": "787-768-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37-19 CALLE 36",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855502",
            "telephone_number": "787-768-4993",
            "fax_number": "787-768-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "fernandez juncos st .edificio vanessa",
            "address_2": "B-5",
            "address_purpose": "LOCATION",
            "city": "carolina",
            "state": "PR",
            "postal_code": "00985",
            "country_code": "US",
            "telephone_number": "787-768-4993",
            "fax_number": "787-768-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ LOPEZ",
        "first_name": "MICHELLE",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PR",
            "license": "15624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.