Antonio Tombo Lopez Jr, NP is a medicare enrolled "Nurse Practitioner" physician in Conyers, Georgia. His current practice location is
1412 Milstead Ave Ne Ste 300, Conyers, Georgia. You can reach out to his office (for appointments etc.) via phone at
(404) 918-2320.
Antonio Tombo Lopez Jr is licensed to practice in Georgia (license number RN249427) 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 1952183774.
Physician's Profile
Full Name | Antonio Tombo Lopez Jr |
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Gender | Male |
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Speciality | Nurse Practitioner |
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Location | 1412 Milstead Ave Ne Ste 300, Conyers, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1952183774
- Provider Enumeration Date: 10/17/2023
- Last Update Date: 02/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 5496192726
- Enrollment ID: I20240322001157
Medical Identifiers
Medical identifiers for Antonio Tombo Lopez Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952183774 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RH0003X | Internal Medicine - Hematology & Oncology | RN249427 (Georgia) | Secondary |
363L00000X | Nurse Practitioner | RN249427 (Georgia) | 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. Antonio Tombo Lopez Jr allows following entities to bill medicare on his behalf.
Entity Name | Piedmont Providers Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1548273592 PECOS PAC ID: 9830082825 Enrollment ID: O20040204000321 |
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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. Antonio Tombo Lopez Jr 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 |
Antonio Tombo Lopez Jr, NP 2001 Peachtree Rd Ne Ste 645, Atlanta, GA 30309-1476 Ph: (404) 482-9325 | Antonio Tombo Lopez Jr, NP 1412 Milstead Ave Ne Ste 300, Conyers, GA 30012-3877 Ph: (404) 918-2320 |
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