Individual provider Active NPI

Jonathan D Lopez, MD

  • Hematology & Oncology Physician
  • Fairfield, CA
National Provider Identifier
1881682714
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A102015 Issued in CA
Practice address
1860 Pennsylvania Ave
Suite 230
Fairfield, CA 94533-0000
Phone
(707) 646-4000
Fax
(707) 646-4004
NPI assigned
Oct 13, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A102015 CA Primary

Addresses

Primary practice location

1860 Pennsylvania Ave
Suite 230
Fairfield, CA 94533-0000

Mailing address

1860 Pennsylvania Ave
Suite 230
Fairfield, CA 94533-3590
Phone (707) 646-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111025000035 CA Practitioner - Hematology/Oncology 4587849971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1860 Pennsylvania Ave
Suite 230
Fairfield, CA 94533-3550
Phone (707) 646-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102015CAMDMarriage & Family Therapist
A102015CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Aug 15, 2011 Accepting new patients
Northbay Healthcare Group CurrentSince Aug 15, 2011 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Northbay Physicians Surgery Center LLC Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1860 Pennsylvania Ave
Ste 230
Fairfield, CA 94533
Phone (707) 646-4000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881682714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE",
            "address_2": "SUITE 230",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333590",
            "telephone_number": "707-646-4000",
            "fax_number": "707-646-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE",
            "address_2": "SUITE 230",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945330000",
            "telephone_number": "707-646-4000",
            "fax_number": "707-646-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A102015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.