1. Home
  2. Directory
  3. Connecticut
  4. Danbury
  5. Nurse Practitioner
  6. NPI Profile

JUSTIN LOPES APRN
NPI 1649855024
Nurse Practitioner - Family in Danbury, CT

Active since March 16, 2021PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
1 EDGEWOOD ST, DANBURY, CT 06810(203) 512-0961 Get Directions Write a Review

NPPES record last updated: March 16, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Justin Lopes Aprn NPPES

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

JUSTIN LOPES APRN (NPI 1649855024) is an individual family provider in Danbury, Connecticut, licensed in Connecticut (F02211147) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1649855024
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJUSTIN LOPESCredential: APRN
Location Address1 EDGEWOOD STDanbury, CT 06810-5329
Mailing Address1 Edgewood StDanbury, CT 06810-5329 · (203) 512-0961
Phone(203) 512-0961
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 16, 2021
NPPES CertifiedMarch 12, 2021
✔ NPI 1649855024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CT · F02211147
1 EDGEWOOD ST, Danbury, CT 06810
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Justin Lopes Aprn 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 ID5092114199
PECOS Enrollment IDI20210521001363
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.

Medicare Billing Reassignment

Medicare enrollment records show Justin Lopes reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Yale University
28 mi
Adult Mental Health
95 CIRCULAR AVE
Hamden, CT 06514
  • Reassigned Medicare billing, Connecticut enrollment
  • 3,728 clinicians in this Medicare group
NPI 1134391824 (203) 288-6253

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
68 services56 patients
Reprogramming of cerebrospinal fluid shunt 62252
Reprogramming of a cerebrospinal fluid shunt is a process to adjust the device that helps regulate the flow of fluid around your brain. This adjustment ensures the shunt is working correctly, reducing symptoms and improving your comfort.
55 services43 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
44 services31 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
29 services29 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
22 services22 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
19 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06810 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

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 Justin Lopes's NPI number?

The NPI number for Justin Lopes is 1649855024. It was assigned to this individual provider in the NPPES registry on March 16, 2021.

Where is Justin Lopes located?

Justin Lopes practices at 1 Edgewood St, Danbury, CT 06810. The listed phone number is (203) 512-0961.

What is Justin Lopes's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Justin Lopes enrolled in Medicare?

Yes. Justin Lopes 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.

Which organization bills Medicare for Justin Lopes's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Lopes reassigns Medicare benefits to Yale University (Hamden, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justin Lopes's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Justin Lopes accept?

Health plans from Anthem Blue Cross and Blue Shield list Justin Lopes 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 Justin Lopes was last updated on March 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.