Individual provider Active NPI

Robert Lopez, CRNA

  • Certified Registered Nurse Anesthetist
  • Travis Afb, CA
National Provider Identifier
1881068252
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000480 Issued in CA
Practice address
101 Bodin Cir
Travis Afb, CA 94535-1809
Phone
(707) 423-3735
NPI assigned
Nov 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 770385 CA
Certified Registered Nurse Anesthetist 367500000X 95000480 CA Primary

Addresses

Primary practice location

101 Bodin Cir
Travis Afb, CA 94535-1809

Mailing address

101 Bodin Cir
Travis Afb, CA 94535-1809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716001579 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719301290 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of FresnoGroup PAC ID 8527967082, 64 clinicians
Omni Anesthesia Associates IncGroup PAC ID 4385638303, 8 clinicians

Practice addresses (Care Compare)

1360 E Spruce Ave
Suite 101a
Fresno, CA 93720-3378
Phone (559) 437-5645

2365 E Fir Ave
Fresno, CA 93720-8016
Phone (559) 797-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
95000480CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 18, 2020 Accepting new patients
Central California Anesthesiology Solutions Nurse Anesthetist, Certified Registered CurrentSince Jun 13, 2020 Accepting new patients

Locations

4500 Morning Dr
Ste 102
Bakersfield, CA 93306
Phone (661) 437-4140

7300 N Fresno St
Fresno, CA 93720
Phone (207) 448-4500

2365 E Fir Ave
Fresno, CA 93720
Phone (559) 797-9000

445 S Cedar Ave
Fresno, CA 93702
Phone (559) 459-4000

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

1250 E Almond Ave
Madera, CA 93637
Phone (559) 675-5501

350 S Oak Ave
Oakdale, CA 95361
Phone (209) 847-3011

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1448150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1881068252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-22",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "770385",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.