JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1356901623

JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT) is a healthcare provider. based in The colony, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PHYSICIAN ASSISTANT. The NPI Number for JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT) is 1356901623

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT)
NPI
1356901623
Phone
Not provided
Address
5702 SAINTSBURY DR APT 123
Enumeration Date
18 June 2019
Last Update Date
12 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2019 (7 years ago)
PAC ID
9537491972
Group Practice PAC ID
1355254210
Professional Enrollment ID
I20191104002553
Address ID
TX752461608DA4001XSTXX300
Telehealth
Yes

Contacts

Secure Messaging
jlopez577902@direct.sw.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness85
Years active:6State licenses:0Other namesUpdated within 12 months

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT)

  • 5702 SAINTSBURY DR APT 123

    THE COLONY, TX 750565488

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $2,269.

Total Amount is formed as General ($2,269) + Research ($0) + Ownership ($0) = $2,269.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($2,172).

Total Amount

$2,269

General + Research + Ownership

Payments

16

Total payment records

General Amount

$2,269

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-11-04

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191104002553IPhysician AssistantTXTBD

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 75056)

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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: 1355254210View full group profile
NameSpecialtyState
Radiation OncologyTX
Nurse PractitionerTX
Internal MedicineTX
-TX
-TX
Clinical Social WorkerTX
-TX
Nurse PractitionerTX
Orthopedic SurgeryTX
Clinical PsychologistTX

Reviews

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Frequently asked questions

What unique ID ties claims to JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT)?
NPI 1356901623 is assigned to JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT) under the national enumeration system.
Is JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT) active in the national directory?
JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT)'s public NPI profile is in an active state.
Does JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT) list a primary specialty?
If you are matching referrals, note Physician Assistant for JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT). Clinical services aligned with this taxonomy classification.
Where does public data place JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT)?
The snapshot lists The Colony, Texas for JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT); download NPPES for the complete set.
How can I contact JENNIFER KNICKERBOCKER LOPEZ (PHYSICIAN ASSISTANT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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