Ms Tisa Lynn Lopez, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Tucson, Arizona. Her current practice location is
4729 E Camp Lowell Dr, Tucson, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 838-3540.
Ms Tisa Lynn Lopez is licensed to practice in Arizona (license number 260967) 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 1447928270.
Physician's Profile
| Full Name | Ms Tisa Lynn Lopez |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 4729 E Camp Lowell Dr, Tucson, Arizona |
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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: 1447928270
- Provider Enumeration Date: 09/07/2021
- Last Update Date: 09/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 4183021033
- Enrollment ID: I20210921000850
Medical Identifiers
Medical identifiers for Ms Tisa Lynn Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1447928270 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | RN172023 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 260967 (Arizona) | 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. Ms Tisa Lynn Lopez allows following entities to bill medicare on her behalf.
| Entity Name | Pima Heart Physicians Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730137480 PECOS PAC ID: 6507751294 Enrollment ID: O20040220000507 |
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| Entity Name | Carelon Medical Partners Of Arizona Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972879773 PECOS PAC ID: 6406010552 Enrollment ID: O20120621000233 |
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| Entity Name | Tucson Physician Group Holdings Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356726939 PECOS PAC ID: 0547560070 Enrollment ID: O20151204001261 |
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| Entity Name | West Coast Wound And Skin Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437675980 PECOS PAC ID: 7315212834 Enrollment ID: O20200803000710 |
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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. Ms Tisa Lynn 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 |
Ms Tisa Lynn Lopez, FNP-C 3709 N Campbell Ave Ste 201, Tucson, AZ 85719-1563 Ph: (520) 838-3540 | Ms Tisa Lynn Lopez, FNP-C 4729 E Camp Lowell Dr, Tucson, AZ 85712-1256 Ph: (520) 838-3540 |
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