Miguel Lopez

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17 Manhattan SQ
Hampton, VA 23666-5843

Phone

(757) 838-8030

NPI assigned

Dec 11, 2023

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 VA, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlopez@aiderm.trimed.direct-ci.com

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.

• St. Paul Place Specialists, Inc.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Baltimore, MD
  • NPI 1871549196
  Medicare reassignment Care Compare group
• Saint Paul Place Specialists, Inc.

  • Dermatology Physician
  • Baltimore, MD
  • NPI 1528014842

  Single Specialty

  NPD
• St Paul Place Specialists Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1497707681

  Single Specialty

  NPD
• Alexandria Associates in Dermatology, PC

  • Dermatology Physician
  • Alexandria, VA
  • NPI 1043389331

  Single Specialty

  NPD (past)
• Saint Paul Place Specialists, Inc.

  • Physical Therapist
  • Baltimore, MD
  • NPI 1346292422

  Single Specialty

  NPD (past)

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

• Mercy Medical Center Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1144282583
  Care Compare affiliation

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1861269664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 HUNTERS CHASE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235184449",
            "telephone_number": "210-364-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MANHATTAN SQ",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665843",
            "telephone_number": "757-838-8030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7101 Hunters Chase",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235184449",
            "country_code": "US",
            "telephone_number": "210-364-9886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MIGUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Logan, SLPD, CCC-SLP, BCS-S
• Haley Durrette Logan, D.C.
• Cari Ann Logsdon, RN
• Taylor Lombardo, PSYD
• Angel Lopez Nuno, LMSW
• Susan Lum Lopresti, M.D.
• Lotus Labs LLC
• Suzanne Claire Loughman, LPC, CSOTP
• Claude Louis, MD
• Louise W. Eggleston Center, Inc.

• Physician Assistant in Hampton, VA
• Providers in Hampton, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.
• 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.