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DR. HIGINIO LOPEZ M.D.
NPI 1427130640
Internal Medicine in New Castle, DE

Active since October 19, 2006PECOS EnrolledAccepts Medicare Assignment
1901 N DUPONT HWY, NEW CASTLE, DE 19720(302) 255-2935(302) 255-4478 Get Directions Write a Review

NPPES record last updated: July 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Higinio Lopez M.d. NPPES

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

DR. HIGINIO LOPEZ M.D. (NPI 1427130640) is an individual internal medicine provider in New Castle, Delaware, licensed in Pennsylvania (MD049121L) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Acmh Hospital, and maintains a secondary practice location in Kittanning.

NPPES Registry Identity

NPI1427130640
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. HIGINIO LOPEZCredential: M.D.
Location Address1901 N DUPONT HWYNew Castle, DE 19720-1160
Mailing Address4 Scottfield DrNewark, DE 19713-2739 · (302) 981-9000 · Fax (302) 255-4478
Phone(302) 255-2935
Fax(302) 255-4478
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateOctober 19, 2006
Last NPPES UpdateJuly 23, 2024
NPPES CertifiedJuly 23, 2024
✔ NPI 1427130640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD049121L
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1901 N DUPONT HWY, New Castle, DE 19720
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Secondary Practice Location 1

Location 11 Nolte DrKittanning, PA 16201-7111 · Phone (724) 543-8500

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Dr. Higinio Lopez M.d. 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 ID5597825737
PECOS Enrollment IDI20081118000765
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
39 services39 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
16 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Acmh Hospital

Acute Care Hospitals · Kittanning, PA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390163
LocationOne Nolte DriveKittanning, PA 16201 · Armstrong County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19720 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
$131.15 typical visit price
range $57.12 – $173.08
Typical copayment $32.78 (range $14.28 – $43.27)
Most-billed visit code 99204
Established Patient
$100.68 typical visit price
range $18.36 – $141.05
Typical copayment $25.17 (range $4.59 – $35.26)
Most-billed visit code 99214
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 20

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

DR. MARIA CUOCOLO MANCUSO M.D.
Family Medicine
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (302) 255-4401
JENNIFER MARIE BROWN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (302) 893-1171
NADEEM AFZAL M.D
Psychiatry & Neurology (Psychiatry)
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (302) 255-2707
ANISSA NURSE
Physical Therapy Assistant
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (302) 255-2700
DR. BRIAN MICHAEL SIMON PAY.D
Psychologist (Clinical)
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (302) 255-2898
DR. SARA DENISE PEREZ-PUJOLS MD
Psychiatry & Neurology (Psychiatry)
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (302) 255-2700
DR. NIRAJ SANGROULA MD
Psychiatry & Neurology (Psychiatry)
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (571) 430-9944
KANIDA TASSNIYOM CHARUWORN MD
Psychiatry & Neurology (Psychiatry)
1901 N DUPONT HWY
NEW CASTLE, DE 19720
New Castle County (302) 255-2700

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 Higinio Lopez's NPI number?

The NPI number for Higinio Lopez is 1427130640. It was assigned to this individual provider in the NPPES registry on October 19, 2006.

Where is Higinio Lopez located?

Higinio Lopez practices at 1901 N Dupont Hwy, New Castle, DE 19720. The listed phone number is (302) 255-2935.

What is Higinio Lopez's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Higinio Lopez enrolled in Medicare?

Yes. Higinio 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 Higinio Lopez accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Higinio 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.

Is Higinio Lopez affiliated with any hospitals?

According to CMS data, Higinio Lopez is affiliated with Acmh Hospital.

When was this NPI record last updated?

The NPPES record for Higinio Lopez was last updated on July 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.