Mario Alberto Lopez, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21385 Issued in CA

Practice address

8788 Jamacha Rd
Spring Valley, CA 91977-4035

Phone

(619) 515-2555

NPI assigned

Jun 3, 2009

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Family Health Centers of San Diego, Inc

  dba Logan Heights Family Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment Care Compare group
• San Diego Neurotrauma Associates Inc

  • Neurological Surgery Physician
  • San Diego, CA
  • NPI 1780822213
  Medicare reassignment
• Family Health Centers of San Diego Inc

  dba Rice Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Chula Vista, CA
  • NPI 1083959464
  NPD
• Family Health Centers of San Diego Inc

  dba Logan Heights Family Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1528331287
  NPD
• Family Health Centers of San Diego, Inc

  dba Escondido Physical Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Family Health Centers of San Diego, Inc

  dba Grossmont Spring Valley Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Spring Valley, CA
  • NPI 1508801069
  NPD
• Family Health Centers of San Diego, Inc.

  dba Hillcrest Family Health Center-Annex

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1669827598
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD (past)

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1932335080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8788 JAMACHA RD",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919774035",
            "telephone_number": "619-515-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2325 Commercial St Ste 1400",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921131195",
            "country_code": "US",
            "telephone_number": "619-515-2422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "823 Gateway Center Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024541",
            "country_code": "US",
            "telephone_number": "619-515-2300",
            "fax_number": "619-906-4564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 6th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921014300",
            "country_code": "US",
            "telephone_number": "619-515-2430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARIO",
        "middle_name": "ALBERTO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "W5352",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert S. Lipetz, D.O.
• Jennifer Loi
• Michael Long
• Cynthia Iliana Lopez, PHARMACY TECHNICIAN
• Issai Lopez
• Yesenia Lopez
• Luxecare LLC
• Irene Luy
• Shelton Ray Lynch
• James George Maccoll, RN

• Medical Physician Assistant in Spring Valley, CA
• Providers in Spring Valley, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.