Mr Abraham Dagoberto Lopez Jr, PA - Medicare Physician Assistant in Phoenix, AZ

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Mr Abraham Dagoberto Lopez Jr, PA is a medicare enrolled "Physician Assistant" physician in Phoenix, Arizona. His current practice location is 5102 W Campbell Ave, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (623) 848-5000.

Mr Abraham Dagoberto Lopez Jr is licensed to practice in Arizona (license number 2816) 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 1073599619.

Contact Information

Mr Abraham Dagoberto Lopez Jr, PA
5102 W Campbell Ave,
Phoenix, AZ 85031-1703
(623) 848-5000
Not Available

Map and Direction




Physician's Profile

Full NameMr Abraham Dagoberto Lopez Jr
GenderMale
SpecialityPhysician Assistant
Location5102 W Campbell Ave, Phoenix, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1073599619
  • Provider Enumeration Date: 12/15/2005
  • Last Update Date: 12/22/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 6103802103
  • Enrollment ID: I20040629001111

Medical Identifiers

Medical identifiers for Mr Abraham Dagoberto Lopez Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073599619NPI-NPPES
817827MedicaidAZ
860373636OtherAZHUMANA-GROUP #
453051001OtherAZGROUP HEALTH GROUP
3987220OtherAZEYECARE
AW1436OtherAZHEALTHNET GROUP

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 2816 (Arizona)Secondary
363A00000XPhysician Assistant 2816 (Arizona)Primary

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. Mr Abraham Dagoberto 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 AddressPractice Location Address
Mr Abraham Dagoberto Lopez Jr, PA
4518 W Paradise Dr,
Glendale, AZ 85304-3027

Ph: (602) 320-0580		Mr Abraham Dagoberto Lopez Jr, PA
5102 W Campbell Ave,
Phoenix, AZ 85031-1703

Ph: (623) 848-5000

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.