Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Marie Lopez, RPA-C

Individual provider Surgical Physician Assistant · NPI 1477828952

Jacqueline Marie Lopez, RPA-C is a Physician Assistant in Bay Shore, New York. Qualified in 2012, 14 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
14
Licensed in
NY
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (516) 521-3744
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 259 1st St, Mineola, NY 11501-3957 — (516) 663-0333

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 23015496 (NY)
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1477828952
Entity typeIndividual (Type 1)
GenderFemale
Credentials RPA-C
Sole proprietorNo
NPI enumeratedMarch 15, 2012
Last updated in NPPESJune 13, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Bay Shore