Carlos Ivan Enciso Lopez, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301512806 Issued in MI

Practice address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone

(650) 723-5948

NPI assigned

Jun 3, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, WA2 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 2

Specialty

Emergency Medicine

Education

University of Washington School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Michigan Emergency Physicians LLPGroup PAC ID 7113910399, 11 clinicians

Eastside Emergency Physicians PLLCGroup PAC ID 5193725372, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337

Merit-based Incentive Payment System (MIPS)

Final score

86.2 of 100Reported as group

Quality

82.07

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northern Michigan Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Escanaba, MI
  • NPI 1417972183
  Medicare reassignment Care Compare group NPD
• Eastside Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Issaquah, WA
  • NPI 1689683229
  Medicare reassignment Care Compare group
• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment
• Northern Michigan Emergenc Physicians, LLP

  • Emergency Medicine Physician
  • Sault Sainte Marie, MI
  • NPI 1922105113
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Francis Hospital

  • Critical Access Hospital
  • Escanaba, MI
  • NPI 1922058551
  Care Compare affiliation

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1841866399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-5948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Veterans Blvd",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940632037",
            "country_code": "US",
            "telephone_number": "650-299-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Ludington St",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498291300",
            "country_code": "US",
            "telephone_number": "906-786-5707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENCISO LOPEZ",
        "first_name": "CARLOS",
        "middle_name": "IVAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-03",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A203750",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301512806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Joy Emo, PA-C
• Samantha Rae Emont, MD
• Sara Coleman Emrich, NP
• Derick Chike En'Wezoh, M.D.
• Sheila Sree Enamandram, MD
• Gerda Constance Endemann, PH.D.
• Ekene Ada Enemchukwu, MD
• Monica Vanessa Eneriz Wiemer, M.D.
• Winnie Wai Peng Eng, PA
• Joshua Engel

• Emergency Medicine Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.