Eustorgio A Lopez, MD, DDS is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Davie, Florida. His current practice location is
3200 S University Dr, Davie, Florida. You can reach out to his office (for appointments etc.) via phone at
(954) 262-7153.
Eustorgio A Lopez is licensed to practice in Florida (license number ME74506) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1730145061.
Healthcare Provider's Profile
| Full Name | Eustorgio A Lopez |
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| Gender | Male |
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| Speciality | Oral & Maxillofacial Surgery |
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| Location | 3200 S University Dr, Davie, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1730145061
- Provider Enumeration Date: 04/25/2006
- Last Update Date: 07/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 9830286228
- Enrollment ID: I20071101000270
Medical Identifiers
Medical identifiers for Eustorgio A Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730145061 | NPI | - | NPPES |
| 015641700 | Medicaid | FL | |
| 2686961-00 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN 13112 (Florida) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | ME74506 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Eustorgio A Lopez allows following entities to bill medicare on his behalf.
| Entity Name | Nova Southeastern University Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700924511
PECOS PAC ID: 4486568896
Enrollment ID: O20031118000987 |
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| Entity Name | University Of Miami |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013967827
PECOS PAC ID: 3274795109
Enrollment ID: O20200406001006 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Eustorgio A Lopez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Eustorgio A Lopez, MD, DDS
3200 S University Dr,
Davie, FL 33328-2018
Ph: (954) 262-7153 | Eustorgio A Lopez, MD, DDS
3200 S University Dr,
Davie, FL 33328-2018
Ph: (954) 262-7153 |
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