Chrystal Vergara-lopez, PHD in Riverside, RI - Medicare Psychologist Provider

Chrystal Vergara-lopez, PHD is a medicare enrolled "Psychologist - Clinical" provider in Riverside, Rhode Island. Her current practice location is 375 Wampanoag Trl, Riverside, Rhode Island. You can reach out to her office (for appointments etc.) via phone at (401) 649-4050.

Chrystal Vergara-lopez is licensed to practice in Rhode Island (license number PS01743) 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 1932676806.

Contact Information

	Chrystal Vergara-lopez, PHD
	375 Wampanoag Trl, Riverside, RI 02915-2232
	(401) 649-4050
	(401) 649-4051

Map and Direction

Healthcare Provider's Profile

Full Name	Chrystal Vergara-lopez
Gender	Female
Speciality	Psychologist - Clinical
Location	375 Wampanoag Trl, Riverside, Rhode Island
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932676806
Provider Enumeration Date: 10/30/2018
Last Update Date: 09/02/2025

Medicare PECOS Information:

PECOS PAC ID: 9133465826
Enrollment ID: I20190117001181

Medical Identifiers

Medical identifiers for Chrystal Vergara-lopez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932676806	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PS01743 (Rhode Island)	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. Chrystal Vergara-lopez allows following entities to bill medicare on her behalf.

Entity Name	Lifespan Physician Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548506793 PECOS PAC ID: 2567455082 Enrollment ID: O20130528000089

Entity Name	Coastal Medical Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780273540 PECOS PAC ID: 0345658316 Enrollment ID: O20210427001413

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. Chrystal Vergara-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
Chrystal Vergara-lopez, PHD Dept 3010, Po Box 986524, Boston, MA 02298-6524 Ph: (401) 443-4992	Chrystal Vergara-lopez, PHD 375 Wampanoag Trl, Riverside, RI 02915-2232 Ph: (401) 649-4050

Reviews and Comments

Psychologist in Riverside, RI

Dr. Vamsi C Tummalachetty, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1011 Veterans Memorial Pkwy, Riverside, RI 02915 Phone: 401-432-1000
Dr. Andrea Lillian Gold, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1011 Veterans Memorial Pkwy, Riverside, RI 02915 Phone: 401-432-1000 Fax: 401-432-1500
David Lichtenstein, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1011 Veterans Memorial Pkwy, Riverside, RI 02915 Phone: 401-432-1000
Bryana Elizabeth Killion, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 1011 Veterans Memorial Pkwy, Riverside, RI 02915 Phone: 401-432-1618
Dr. Lisa Faille, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2 Village Grn N Apt C, Riverside, RI 02915 Phone: 401-481-1914
James Andrew Brcak, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1011 Veterans Memorial Pkwy, Riverside, RI 02915 Phone: 401-432-1000 Fax: 401-432-1500
Samuel V. Highland, PSYD Psychologist Medicare: Medicare Enrolled Practice Location: 1275 Wampanoag Trl Ste 3c, Riverside, RI 02915 Phone: 401-206-0304 Fax: 855-595-1087

Chrystal Vergara-lopez, PHD - Medicare Psychologist in Riverside, RI