Individual provider Active NPI

Michelle Margotta Lopez

  • Family Nurse Practitioner
  • Holmdel, NJ
National Provider Identifier
1952185969
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14903000 Issued in NJ
Practice address
23 Main St
Holmdel, NJ 07733-2136
Phone
(732) 571-1000
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ14903000 NJ Primary

Addresses

Primary practice location

23 Main St
Holmdel, NJ 07733-2136

Mailing address

79 Diven St
Springfield, NJ 07081-2801
Phone (908) 265-0355

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231219001634 NJ Practitioner - Nurse Practitioner 6608226543 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Anesthesia Associates, PAGroup PAC ID 4082609003, 16 clinicians

Practice addresses (Care Compare)

695 Chestnut St
Union, NJ 07083-7200
Phone (908) 851-6171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ14903000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VPS Medical Services, PC CurrentSince Sep 27, 2023 Accepting new patients
Union Anesthesia Associates, PA CurrentSince May 1, 2024 Accepting new patients
Barnabas Health Medical Group, PC PastSince Sep 5, 2023 Accepting new patients

Locations

3600 State Route 66
Fl 4
Tinton Falls, NJ 07753
Phone (732) 241-4194

695 Chestnut St
Union, NJ 07083
Phone (908) 688-6565

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1952185969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 DIVEN ST",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070812801",
            "telephone_number": "908-265-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MAIN ST",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332136",
            "telephone_number": "732-571-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MICHELLE",
        "middle_name": "MARGOTTA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14903000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.