Individual provider Active NPI

Louis Alfred Lopez, MD

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
National Provider Identifier
1922117571
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01045695A Issued in IN
Practice address
604 W Berry St
Fort Wayne, IN 46802-2106
Phone
(260) 423-1331
Fax
(260) 422-1046
NPI assigned
Aug 29, 2006
Last updated
Sep 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01045695A IN Primary

Addresses

Primary practice location

604 W Berry St
Fort Wayne, IN 46802-2106

Mailing address

604 W Berry St
Fort Wayne, IN 46802-2106
Phone (260) 423-1331

Other practice location 1

285 W 12th St Ste 105
Peru, IN 46970-1654
Phone (765) 475-8973

Other practice location 2

10020 DuPont Circle Ct Ste 140
Fort Wayne, IN 46825-1621
Phone (260) 489-4100

Other identifiers 1

IdentifierTypeStateIssuer
200108750AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address louis.lopez@acc.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20120111000276 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional CardiologyPractitioner - Peripheral Vascular DiseasePractitioner - Internal Medicine 8921179557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Cardiology, Peripheral Vascular Disease
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen County Cardiology, LLCGroup PAC ID 9133290752, 3 clinicians

Practice addresses (Care Compare)

10020 Dupont Circle CT
Suite 140
Fort Wayne, IN 46825-1621
Phone (260) 489-4100

604 W Berry St
Fort Wayne, IN 46802-2106

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.85 of 100Reported as individual
Quality
80.33
Improvement activities
40
Cost
73.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting20
Pacemaker insertion or repair1-10
Varicose vein removal12
Leg revascularization (restoring blood flow)27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045695AINMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen County Cardiology LLC Cardiovascular Disease CurrentSince Oct 10, 1998 Accepting new patients
American Vein Institute LLC PastSince Jan 1, 2017 Accepting new patients

Locations

10020 DuPont Circle Ct
Ste 140
Fort Wayne, IN 46825
Phone (260) 418-2427

604 W Berry St
Fort Wayne, IN 46802
Phone (219) 423-1331

285 W 12th St
Ste 105
Peru, IN 46970
Phone (574) 372-7676

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72187
  • Direct secure messaging: louis.lopez@acc.directbygreenway.com

Organizations & group practices 2

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 8

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1922117571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W BERRY ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022106",
            "telephone_number": "260-423-1331",
            "fax_number": "260-422-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 W BERRY ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022106",
            "telephone_number": "260-423-1331",
            "fax_number": "260-422-1046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 W 12th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Peru",
            "state": "IN",
            "postal_code": "469701654",
            "country_code": "US",
            "telephone_number": "765-475-8973",
            "fax_number": "765-475-8974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10020 DuPont Circle Ct Ste 140",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251621",
            "country_code": "US",
            "telephone_number": "260-489-4100",
            "fax_number": "260-489-4188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "LOUIS",
        "middle_name": "ALFRED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01045695A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200108750A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "louis.lopez@acc.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "604 W Berry St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468022106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.