1. Home
  2. Directory
  3. Florida
  4. Palm Coast
  5. General Practice
  6. NPI Profile

ELIECER BARRUETA LOPEZ MD
NPI 1083271357
General Practice in Palm Coast, FL

Active since May 22, 2019PECOS Enrolled
57 TOWN CT STE 218, PALM COAST, FL 32164(386) 368-8531 Get Directions Write a Review

NPPES record last updated: January 24, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 14, 2023, May 22, 2019 (2 updates tracked since 2019).

About Eliecer Barrueta Lopez Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIECER BARRUETA LOPEZ MD (NPI 1083271357) is an individual general practice provider in Palm Coast, Florida, licensed in Puerto Rico (23236) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1083271357
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameELIECER BARRUETA LOPEZCredential: MD
Location Address57 TOWN CT STE 218Palm Coast, FL 32164-2425
Mailing Address1768 Richard LnWest Palm Beach, FL 33406-6576 · (561) 319-5157
Phone(386) 368-8531
Sole ProprietorYes
Medical School CMSOtherGraduated 1991
Enumeration DateMay 22, 2019
Last NPPES UpdateJanuary 24, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 24, 2025
✔ NPI 1083271357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in PR · 23236
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedInternal MedicineTaxonomy 207R00000X · License ACN1619 (FL)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 15058-I (PR)
57 TOWN CT STE 218, Palm Coast, FL 32164
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eliecer Barrueta Lopez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID446771489
PECOS Enrollment IDI20250306003737
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eliecer Barrueta Lopez's NPI number?

The NPI number for Eliecer Barrueta Lopez is 1083271357. It was assigned to this individual provider in the NPPES registry on May 22, 2019.

Where is Eliecer Barrueta Lopez located?

Eliecer Barrueta Lopez practices at 57 Town Ct Ste 218, Palm Coast, FL 32164. The listed phone number is (386) 368-8531.

What is Eliecer Barrueta Lopez's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Eliecer Barrueta Lopez enrolled in Medicare?

Yes. Eliecer Barrueta Lopez is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Eliecer Barrueta Lopez was last updated on January 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.