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MR. SAMUEL LOPEZ PA-C
NPI 1114167756
Physician Assistant - Surgical in Vancouver, WA

Active since February 23, 2009PECOS EnrolledAccepts Medicare Assignment
203 SE PARK PLAZA DR STE 140, VANCOUVER, WA 98684(800) 813-2000 Get Directions Write a Review

NPPES record last updated: March 6, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 6, 2022, Apr 12, 2019 (2 updates tracked since 2019).

About Mr. Samuel Lopez Pa-c NPPES

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

MR. SAMUEL LOPEZ PA-C (NPI 1114167756) is an individual surgical provider in Vancouver, Washington, licensed in Colorado (PAL-3102) and active in the NPI registry since February 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1114167756
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. SAMUEL LOPEZCredential: PA-C
Location Address203 SE PARK PLAZA DR STE 140Vancouver, WA 98684-5887
Mailing Address203 Se Park Plaza Dr Ste 140Vancouver, WA 98684-5887 · (800) 813-2000
Phone(800) 813-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateFebruary 23, 2009
Last NPPES UpdateMarch 6, 20222 updates tracked since enumeration
NPPES CertifiedMarch 6, 2022
✔ NPI 1114167756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CO · PAL-3102
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA156712 (OR)
203 SE PARK PLAZA DR STE 140, Vancouver, WA 98684
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Samuel Lopez Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486836160
PECOS Enrollment IDI20120301000486, I20181108002863
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.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JACOB WAYNE HECK DPM
Podiatrist
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (800) 813-2000
NATHAN W GREENE M.D.
Orthopaedic Surgery
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (360) 449-7002
ELIZABETH HOLLOWAY PA-C
Physician Assistant
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (800) 813-2000
JAMES COWAN MD
Orthopaedic Surgery
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (800) 813-2000
ERIC BENJAMIN SCHUB D.O.
Family Medicine (Sports Medicine)
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (800) 813-2000
ANUSHA IYER DPM
Podiatrist
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (800) 813-2000
DAVID WAYNE GRIFFIN DPM
Podiatrist (Foot Surgery)
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (360) 449-7002
KERRY ANNE MATTHEWS MD
Family Medicine
203 SE PARK PLAZA DR STE 140
VANCOUVER, WA 98684
Clark County (800) 813-2000

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 Samuel Lopez's NPI number?

The NPI number for Samuel Lopez is 1114167756. It was assigned to this individual provider in the NPPES registry on February 23, 2009.

Where is Samuel Lopez located?

Samuel Lopez practices at 203 SE Park Plaza Dr Ste 140, Vancouver, WA 98684. The listed phone number is (800) 813-2000.

What is Samuel Lopez's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Samuel Lopez enrolled in Medicare?

Yes. Samuel Lopez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Samuel Lopez accept?

Health plans from Kaiser Permanente list Samuel Lopez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Lopez was last updated on March 6, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.