PRESTON ERIC LOPEZ PA
NPI 1407111834
Physician Assistant - Surgical in Olympia, WA

Active since July 11, 2012PECOS EnrolledAccepts Medicare Assignment
615 LILLY RD NE STE 100, OLYMPIA, WA 98506(360) 491-4211 Get Directions Write a Review

NPPES record last updated: June 5, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 5, 2026, Aug 24, 2023 (2 updates tracked since 2023).

About Preston Eric Lopez Pa NPPES

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

PRESTON ERIC LOPEZ PA (NPI 1407111834) is an individual surgical provider in Olympia, Washington and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, maintains a secondary practice location in Olympia, and is a graduate of University Of Nebraska College Of Medicine (2012).

NPPES Registry Identity

NPI1407111834
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NamePRESTON ERIC LOPEZCredential: PA
Location Address615 LILLY RD NE STE 100Olympia, WA 98506-5117
Mailing AddressPo Box 368Olympia, WA 98507-0368 · (360) 455-5144 · Fax (360) 491-7536
Sole ProprietorNo
Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 2012
Enumeration DateJuly 11, 2012
Last NPPES UpdateJune 5, 20262 updates tracked since enumeration
NPPES CertifiedJune 5, 2026
NPI 1407111834 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
Also ListedPhysician AssistantTaxonomy 363A00000X
615 LILLY RD NE STE 100, Olympia, WA 98506

Secondary Practice Location 1

Location 13901 Capital Mall Dr SW Ste BOlympia, WA 98502-8654 · Phone (360) 868-6259

Accepted 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

Preston Eric Lopez Pa 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 ID8628483856
PECOS Enrollment IDI20260326003172
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.

Physician Assistant
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Orthopaedic Surgery (Hand Surgery)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Nurse Practitioner
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Orthopaedic Surgery
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Orthopaedic Surgery (Orthopaedic Trauma)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Orthopaedic Surgery (Sports Medicine)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Orthopaedic Surgery (Foot and Ankle Surgery)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407111834, enumerated as an "individual" on July 11, 2012.

The provider is located at 615 LILLY RD NE STE 100 OLYMPIA, WA 98506 and the phone number is (360) 491-4211.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas. Please consult your insurance carrier or call the provider to verify.