MARYALICE LOPEZ MD
NPI 1033554480
Obstetrics & Gynecology in Boise, ID

NPI Status: Active since April 29, 2013

Contact Information

333 N 1ST ST STE 240
BOISE, ID
ZIP 83702
Phone: (208) 338-8900

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 13
Obstetrics & Gynecology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About MARYALICE LOPEZ

This page provides the complete NPI Profile along with additional information for Maryalice Lopez, a women's health care provider established in Boise, Idaho with a medical specialization in Obstetrics & Gynecology and more than 13 years of experience. She graduated from University Of Washington School Of Medicine in 2013. The healthcare provider is registered in the NPI registry with number 1033554480 assigned on April 2013. The practitioner's primary taxonomy code is 207V00000X with license number M14437 (ID). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI: 1033554480
Provider Name: MARYALICE LOPEZ MD
Gender: Female
Entity Type: Individual
Location Address: 333 N 1ST ST STE 240 BOISE, ID 83702
Location Phone: (208) 338-8900
Mailing Address: 333 N 1ST ST STE 240 BOISE, ID 83702
Mailing Phone: (208) 338-8900
Mailing Fax
Medical School Name: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year: 2013
Is Sole Proprietor?: No
Enumeration Date: 04-29-2013
Last Update Date: 12-17-2018
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Women's health care providers like Maryalice Lopez treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Obstetrics & Gynecology
Taxonomy Code: 207V00000X
Type: Allopathic & Osteopathic Physicians
License No.: M14437
License State: ID
Taxonomy Description: An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Moda Health Plan, Inc.

Moda Health Affinity Bronze 7750 - EPO
Moda Health Affinity Bronze 9000 - EPO
Moda Health Affinity Bronze HDHP 7500 - EPO
Moda Health Affinity Gold 1000 - EPO
Moda Health Affinity Gold 1500 - EPO
Moda Health Affinity Gold 250 - EPO
Moda Health Affinity Silver 3000 - EPO
Moda Health Affinity Silver 3400 - EPO
Moda Health Affinity Silver 4500 - EPO
Moda Health Affinity Silver 6000 - EPO
Moda Health Oregon Standard Bronze Affinity - EPO
Moda Health Oregon Standard Gold Affinity - EPO
Moda Health Oregon Standard Silver Affinity - EPO

Mountain Health CO-OP

Connect Bronze Expanded Standard - PPO
Connect Bronze HDHP - PPO
Connect Catastrophic - PPO
Connect Gold - PPO
Connect Gold Standard - PPO
Connect Silver - PPO
Connect Silver Standard - PPO
High Plains Bronze HDHP - PPO
High Plains Bronze Standard Expanded - PPO
High Plains Gold - PPO
High Plains Gold HDHP - PPO
High Plains Gold Standard - PPO
High Plains Silver - PPO
High Plains Silver Standard - PPO
Plus Bronze Expanded - PPO
Plus Bronze Standard Expanded - PPO
Plus Gold - PPO
Plus Gold Standard - PPO
Plus Silver Standard - PPO
ACCESS BRONZE - PPO

PacificSource Health Plans

Navigator Bronze 7000 Exchange - PPO
Navigator Bronze 9200 - PPO
Navigator Bronze HSA 8050 - PPO
Navigator Gold 1500 - PPO
Navigator Gold 1500 Exchange - PPO
Navigator Gold 500 Exchange - PPO
Navigator Silver 3500 Exchange - PPO
Navigator Silver 4000 Exchange - PPO
Navigator Silver 5000 - PPO
Navigator Silver HSA 3500 - PPO
Navigator Standard Expanded Bronze - PPO
Navigator Standard Gold - PPO
Navigator Standard Silver - PPO
PacificSource Oregon Standard Bronze Plan NAV - PPO
PacificSource Oregon Standard Gold Plan NAV - PPO
PacificSource Oregon Standard Silver Plan NAV - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Maryalice Lopez is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Maryalice Lopez is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 9335434067
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20190214002341
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.31 for a new patient copayment and $16.44 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 83702 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $121.27
Minimum New Patient Price $52.44
Maximum New Patient Price $160.17

Average New Patient Copayment $30.31
Minimum New Patient Copayment $13.11
Maximum New Patient Copayment $40.04

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $65.77
Minimum Established Patient Price $16.68
Maximum Established Patient Price $130.93

Average Established Patient Copayment $16.44
Minimum Established Patient Copayment $4.17
Maximum Established Patient Copayment $32.73

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	0	3	3	5	5	4	4	8	0
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	0	6	3	10	5	8	4	16
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 6 + 3 + 1 + 0 + 5 + 8 + 4 + 1 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
									0

The NPI number 1033554480 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.