Active NPI
Kim Tran Lopez, D.O.
- Pediatrics Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OT018884
- Practice address
- 3401 Civic Center Blvd
Division of Pediatric Hospital Medicine
Philadelphia, PA 19104 - Phone
- (215) 327-4414
- NPI assigned
- Jul 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | OS019957 | PA | |
| Pediatrics Physician | 208000000X | OT018884 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Division of Pediatric Hospital Medicine
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Division of Pediatric Hospital Medicine
Philadelphia, PA 19104
Phone (215) 327-4414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS019957 | PA | MD | Pediatrics Physician |
| OT018884 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childen'S Health Care Associates Inc. | Current | Accepting new patients | |
| Childrens Health Care Associates, Inc | Current | Accepting new patients | |
| Childrens Health Care Associates, Inc | Pediatrics | Current | Accepting new patients |
| Childrens Hospital of Philadelphia | Past | Accepting new patients |
Locations
100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040
3401 Civic Center Blvd
Bldg 6TH
Philadelphia, PA 19104
3401 Civic Center Blvd
#M975
Philadelphia, PA 19104
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1598869059
-
- Pediatric Registered Nurse
- Philadelphia, PA
- NPI 1699860643
-
- Pediatric Pulmonology Physician
- Philadelphia, PA
- NPI 1760577712
-
- Children's Hospital
- Philadelphia, PA
- NPI 1215921457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626220800000",
"number": "1952753709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC HOSPITAL MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-327-4414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC HOSPITAL MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-327-4414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN LOPEZ",
"first_name": "KIM",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-05",
"last_updated": "2021-07-14",
"certification_date": "2021-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "OS019957",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "OT018884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.