Individual provider Active NPI

Conrad D Lopez Jr., PT

  • Physical Therapist
  • Maspeth, NY
National Provider Identifier
1841320777
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024920 Issued in NY
Practice address
7241 Grand Ave
Maspeth, NY 11378-1532
Phone
(718) 457-5800
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 024920 NY Primary

Addresses

Primary practice location

7241 Grand Ave
Maspeth, NY 11378-1532

Mailing address

8685 102ND St
Richmond Hill, NY 11418-2033
Phone (718) 846-5493

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

State licenses

LicenseStateTypeSpecialty
024920NYMDFeeding, Eating & Swallowing Occupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Go Physical Therapy and Wellness PC Physical Therapist PastSince Mar 13, 2012 Accepting new patients
All People's Diagnostic Medical Care, P.C. Past Accepting new patients
Maspeth Roura Medical Care PC Past Accepting new patients
MCM Medical Care PC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1841320777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8685 102ND ST",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182033",
            "telephone_number": "718-846-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7241 GRAND AVE",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781532",
            "telephone_number": "718-457-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CONRAD",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maspeth, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.