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IVAN RICARDO LOPEZ LCSW
NPI 1164058756
Social Worker - Clinical in Bristol, FL

Active since March 16, 2020PECOS EnrolledAccepts Medicare Assignment
11033 NW STATE ROAD 20, BRISTOL, FL 32321(850) 643-1155 Get Directions Write a Review

NPPES record last updated: March 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ivan Ricardo Lopez Lcsw NPPES

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

IVAN RICARDO LOPEZ LCSW (NPI 1164058756) is an individual clinical provider in Bristol, Florida, licensed in Florida (16852) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1164058756
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameIVAN RICARDO LOPEZCredential: LCSW
Location Address11033 NW STATE ROAD 20Bristol, FL 32321-6406
Mailing Address5001 Lake Front Dr Apt B1Tallahassee, FL 32303-7171 · (863) 216-9151
Phone(850) 643-1155
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 16, 2020
NPPES CertifiedMarch 16, 2020
✔ NPI 1164058756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in FL · 16852
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
11033 NW STATE ROAD 20, Bristol, FL 32321
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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

Ivan Ricardo Lopez Lcsw 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 ID5395193924
PECOS Enrollment IDI20240820002880
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32321 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $171.84
Typical copayment $0.00 (range $14.00 – $42.96)
Most-billed visit code NA
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

DR. DONNA LYNN SINGLETARY DC
Chiropractor
11033 NW STATE ROAD 20
BRISTOL, FL 32321
Liberty County (850) 643-3000
PANCARE OF FLORIDA, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
11033 NW STATE ROAD 20
BRISTOL, FL 32321
Liberty County (850) 643-1155
MRS. DORCAS B GOODMAN ARNP
Nurse Practitioner (Family)
11033 NW STATE ROAD 20
BRISTOL, FL 32321
Liberty County (850) 643-1155
MR. CRUZ EDGARDO PAGAN DELGADO MD
General Practice
11033 NW STATE ROAD 20
BRISTOL, FL 32321
Liberty County (850) 643-1155

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 Ivan Lopez's NPI number?

The NPI number for Ivan Lopez is 1164058756. It was assigned to this individual provider in the NPPES registry on March 16, 2020.

Where is Ivan Lopez located?

Ivan Lopez practices at 11033 NW State Road 20, Bristol, FL 32321. The listed phone number is (850) 643-1155.

What is Ivan Lopez's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Ivan Lopez enrolled in Medicare?

Yes. Ivan 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.

When was this NPI record last updated?

The NPPES record for Ivan Lopez was last updated on March 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.