SELENE QUETZAL LOPEZ (PT, DPT) – Physical Therapist, NPI 1366170805
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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
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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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231120000951 | I | Physical Therapist In Private Practice | IN | TBD |
| I20251209000546 | I | Physical Therapist In Private Practice | TX | TBD |
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.
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)
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Group practice members
- 1
- 2
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | TX | |
| Physical Therapist In Private Practice | WA | |
| - | TX | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | TX | |
| Physical Therapist In Private Practice | NY | |
| Physical Therapist In Private Practice | TX | |
| - | TX | |
| Physical Therapist In Private Practice | TX | |
| - | TX |
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