Mr Antonio Lopez, MD is a medicare enrolled "Internal Medicine" provider in Hamtramck, Michigan. He went to Michigan State University College Of Human Medicine and graduated in 2021 and has 5 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Henry Ford Health System and his current practice location is
9100 Brombach St, Hamtramck, Michigan. You can reach out to his office (for appointments etc.) via phone at
(313) 972-9000.
Mr Antonio Lopez is licensed to practice in Michigan (license number 4301513129) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1083820203.
Healthcare Provider's Profile
| Full Name | Mr Antonio Lopez |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Experience | 5 Years |
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| Location | 9100 Brombach St, Hamtramck, Michigan |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Antonio Lopez attended and graduated from Michigan State University College Of Human Medicine in 2021
NPI Data:
- NPI Number: 1083820203
- Provider Enumeration Date: 05/15/2007
- Last Update Date: 12/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 2163823147
- Enrollment ID: I20251224000786
Medical Identifiers
Medical identifiers for Mr Antonio Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083820203 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Michigan) | Secondary |
| 163W00000X | Registered Nurse | 4704289261 (Michigan) | Secondary |
| 207R00000X | Internal Medicine | 4301513129 (Michigan) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Henry Ford Health System | 0547178311 | 2550 |
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. Mr Antonio Lopez allows following entities to bill medicare on his behalf.
| Entity Name | Henry Ford Health System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134144801
PECOS PAC ID: 0547178311
Enrollment ID: O20031105000139 |
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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. Mr Antonio 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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Mr Antonio Lopez, MD
1 Ford Pl Ste 3a,
Detroit, MI 48202-3450
Ph: (313) 874-2892 | Mr Antonio Lopez, MD
9100 Brombach St,
Hamtramck, MI 48212-3473
Ph: (313) 972-9000 |
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