Kimberly Lopez, DNP, CNP, FPA-APRN is a medicare enrolled "Nurse Practitioner - Family" physician in Tinley Park, Illinois. Her current practice location is
16036 84th Pl, Tinley Park, Illinois. You can reach out to her office (for appointments etc.) via phone at
(708) 983-3934.
Kimberly Lopez is licensed to practice in Illinois (license number 209022767) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1477144020.
Physician's Profile
| Full Name | Kimberly Lopez |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 16036 84th Pl, Tinley Park, Illinois |
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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: 1477144020
- Provider Enumeration Date: 01/27/2021
- Last Update Date: 05/14/2024
Medicare PECOS Information:
- PECOS PAC ID: 9931514007
- Enrollment ID: I20210223001790
Medical Identifiers
Medical identifiers for Kimberly Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1477144020 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | 277002436 (Illinois) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 277002436 (Illinois) | Secondary |
| 363L00000X | Nurse Practitioner | F01211025 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209022767 (Illinois) | 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. Kimberly Lopez allows following entities to bill medicare on her behalf.
| Entity Name | Mount Sinai Community Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376715896
PECOS PAC ID: 5991600405
Enrollment ID: O20040202001032 |
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| Entity Name | Broadway Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760429609
PECOS PAC ID: 5395749733
Enrollment ID: O20060828000090 |
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| Entity Name | Md @ Home Illinois, Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568758415
PECOS PAC ID: 7810167830
Enrollment ID: O20110831000340 |
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| Entity Name | Edgewood Clinical Services P.c. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295914646
PECOS PAC ID: 3971963901
Enrollment ID: O20230721001228 |
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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. Kimberly 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 |
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Kimberly Lopez, DNP, CNP, FPA-APRN
11309 Distinctive Dr,
Orland Park, IL 60467-9490
Ph: (312) 561-9596 | Kimberly Lopez, DNP, CNP, FPA-APRN
16036 84th Pl,
Tinley Park, IL 60487-7500
Ph: (708) 983-3934 |
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