Alfredo Ivan Lopez, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95029419 Issued in CA

Practice address

135 W Shaw Ave
Fresno, CA 93704-2825

Phone

(559) 258-0968

NPI assigned

Mar 12, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Dermatology Alliance CaGroup PAC ID 4385983634, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Innovative Dermatology Alliance Ca

  dba Peak Dermatology

  • Dermatology Physician
  • Visalia, CA
  • NPI 1083188221
  Medicare reassignment Care Compare group NPD
• La Laser Center, PC, a Professional Medical Corporation

  • Multi-Specialty Clinic/Center
  • San Clemente, CA
  • NPI 1306982855
  NPD
• La Laser Center PC, a Professional Medical Corporation

  dba Visalia Dermatology & Skin Cancer

  • Non-Pharmacy Dispensing Site
  • Visalia, CA
  • NPI 1083247795
  NPD (past)
• La Laser Center PC, a Professional Medical Corporation

  dba Turlock Dermatology & Skin Cancer

  • Non-Pharmacy Dispensing Site
  • Turlock, CA
  • NPI 1356974059
  NPD (past)

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1891553913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 RIESLING AVE",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932308133",
            "telephone_number": "559-707-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042825",
            "telephone_number": "559-258-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ALFREDO",
        "middle_name": "IVAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Lopez
• Alejandra Lopez
• Alexis Lopez
• Alexis Michelle Lopez
• Alexis Rose Lopez
• Alina Lopez
• Alyssa Lynn Lopez
• Alyssa Marie Lopez
• Alyssa Nichole Lopez
• Ana Lopez

• Family Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.