SELENE QUETZAL LOPEZ (PT, DPT) – Physical Therapist, NPI 1366170805

SELENE QUETZAL LOPEZ (PT, DPT) is a healthcare provider. based in Evansville, Indiana. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 1364803 (TX). The NPI Number for SELENE QUETZAL LOPEZ (PT, DPT) is 1366170805

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
SELENE QUETZAL LOPEZ (PT, DPT)
NPI
1366170805
Phone
(812) 461-6716
Address
201 SE 4th Street
Enumeration Date
11 August 2022
Last Update Date
19 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9158556466
Graduation Year
2022 (4 years ago)
PAC ID
3274981931
Group Practice PAC ID
9638150725
Professional Enrollment ID
I20251209000546
Address ID
TX799366280EL11855DRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:3State licenses:2Digital endpointsOther names

1,866 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IN

Provider Addresses for SELENE QUETZAL LOPEZ (PT, DPT)

  • 201 SE 4th Street

    Suite 150

    Evansville, IN 477131350

    Phone: (812) 461-6716

    Fax: (812) 402-1250

    Type: Location

  • 510 N COIT RD STE 2035

    RICHARDSON, TX 750805437

    Phone: (972) 437-2048

    Type: Location

  • 5040 VANDELIA ST

    DALLAS, TX 752358848

    Phone: (830) 719-3594

    Type: Mailing

  • 520 FIELDER NORTH PLZ

    ARLINGTON, TX 760122309

    Phone: (817) 461-4257

    Fax: (817) 461-4865

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231120000951IPhysical Therapist In Private PracticeINTBD
I20251209000546IPhysical Therapist In Private PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 47713)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638150725View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeWA
-TX
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeTX
-TX
Physical Therapist In Private PracticeTX
-TX

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Is SELENE QUETZAL LOPEZ (PT, DPT) listed with a National Provider Identifier?
Yes — SELENE QUETZAL LOPEZ (PT, DPT) has NPI 1366170805 on file in the registry.
Is there an active status for SELENE QUETZAL LOPEZ (PT, DPT)?
For scheduling context, SELENE QUETZAL LOPEZ (PT, DPT) is shown as active in the registry.
What expertise is attributed to SELENE QUETZAL LOPEZ (PT, DPT)?
SELENE QUETZAL LOPEZ (PT, DPT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with SELENE QUETZAL LOPEZ (PT, DPT)?
Directory geography for SELENE QUETZAL LOPEZ (PT, DPT) centers on Evansville, Indiana.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.