MR. ANTONIO LOPEZ (MD) – Internal Medicine Physician, NPI 1083820203
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,218 INTERNAL MEDICINE in MI
Provider Addresses for MR. ANTONIO LOPEZ (MD)
100 MICHIGAN ST NE
GRAND RAPIDS, MI 495032560
Phone: (616) 486-6790
Type: Location
1 FORD PL STE 3A
DETROIT, MI 482023450
Phone: (313) 874-2892
Type: Mailing
9100 BROMBACH ST
HAMTRAMCK, MI 482123473
Phone: (313) 972-9000
Type: Location
1525, Clark Street, Hubbard Farms, Clark Street Technology Park, Southwest Detroit, Detroit, Wayne County, Michigan, 48209, United States
DETROIT, MI 482092136
Phone:
Type: Mailing
CHASS Center, 5635, West Fort Street, Southwest Detroit, Detroit, Wayne County, Michigan, 48209, United States
DETROIT, MI 482093154
Phone: (313) 849-3920
Fax: (734) 492-0443
Type: Location
35180 Nankin Blvd Ste 204
Westland, MI 481852092
Phone: (313) 284-1029
Fax: (734) 492-0443
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: 2025-12-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20251224000786 | I | Internal Medicine | MI | 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 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Gastroenterology, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Clinical Social Worker | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Qualified Audiologist | MI | |
| O P H T H A L M O L O G Y | MI | |
| - | MI | |
| - | MI |
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