Individual provider Active NPI

Tiffany Marie Lopez, NP

  • Family Nurse Practitioner
  • Munster, IN
National Provider Identifier
1972323996
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28220169C Issued in IN
Practice address
901 Macarthur Blvd
Munster, IN 46321-2959
Phone
(219) 836-4569
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 28220169C IN Primary

Addresses

Primary practice location

901 Macarthur Blvd
Munster, IN 46321-2959

Mailing address

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 703-1864

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241202000390 IN Practitioner - Nurse Practitioner 2769917699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munster Radiology Group PCGroup PAC ID 1951299940, 26 clinicians
Powers Health Diagnostic Group LLCGroup PAC ID 8820573280, 25 clinicians

Practice addresses (Care Compare)

1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone (219) 942-0551

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-1700

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28220169CINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munster Radiology Group PC CurrentSince Jan 1, 2025 Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1972323996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-703-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212959",
            "telephone_number": "219-836-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "TIFFANY",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28220169C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.