NICHOLAS RYAN LOPEZ MD
NPI 1104614643
Student in an Organized Health Care Education/Training Program in Phoenix, AZ
About Nicholas Ryan Lopez Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICHOLAS RYAN LOPEZ MD (NPI 1104614643) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Nicholas Ryan Lopez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHOENIX, AZ 85013
PHOENIX, AZ 85013
PHOENIX, AZ 85013
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 Nicholas Lopez's NPI number?
The NPI number for Nicholas Lopez is 1104614643. It was assigned to this individual provider in the NPPES registry on April 25, 2025.
Where is Nicholas Lopez located?
Nicholas Lopez practices at 350 W Thomas Rd, Phoenix, AZ 85013. The listed phone number is (602) 406-3000.
What is Nicholas Lopez's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Nicholas Lopez enrolled in Medicare?
Yes. Nicholas Lopez is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Nicholas Lopez was last updated on April 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Nicholas Ryan Lopez, MD · NPI 1104614643
Student in an Organized Health Care Education/Training Program provider in Phoenix, Arizona. Individual provider, active in the CMS NPPES registry since April 25, 2025.
## Identity
- **NPI:** 1104614643 (Entity type: Individual)
- **Enumerated:** April 25, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 350 W THOMAS RD, Phoenix, AZ 85013-4496
- **Phone:** (602) 406-3000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104614643) · Data from the CMS NPPES public registry.