Brooke Elizabeth Lopez, MMS, PA-C is a medicare enrolled "Physician Assistant - Medical" in Highland, Utah. Her current practice location is
10290 N North County Blvd Ste 200, Highland, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 899-3391.
Brooke Elizabeth Lopez is licensed to practice in Utah (license number 12304844-1206) 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 1912549379.
Provider's Profile
| Full Name | Brooke Elizabeth Lopez |
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| Gender | Female |
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| Speciality | Physician Assistant - Medical |
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| Location | 10290 N North County Blvd Ste 200, Highland, Utah |
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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: 1912549379
- Provider Enumeration Date: 10/16/2019
- Last Update Date: 12/08/2021
Medicare PECOS Information:
- PECOS PAC ID: 7113372558
- Enrollment ID: I20231004004038
Medical Identifiers
Medical identifiers for Brooke Elizabeth Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1912549379 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AM0700X | Physician Assistant - Medical | 12304844-1206 (Utah) | 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. Brooke Elizabeth Lopez allows following entities to bill medicare on her behalf.
| Entity Name | Preservemd LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942881867
PECOS PAC ID: 0244638104
Enrollment ID: O20211006002104 |
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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. Brooke Elizabeth 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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Brooke Elizabeth Lopez, MMS, PA-C
10290 N North County Blvd Ste 200,
Highland, UT 84003-8973
Ph: (801) 899-3391 | Brooke Elizabeth Lopez, MMS, PA-C
10290 N North County Blvd Ste 200,
Highland, UT 84003-8973
Ph: (801) 899-3391 |
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