Active NPI 1043268378 Individual Practitioner Male Practitioner

Dr. Joao A Lopes , MD

Surgery • West Orange, NJ

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Joao Lopes, MD is a certified Surgery practicing in West Orange, NJ. With approximately 27 years of clinical experience since completing medical education in 1999, Dr. Lopes delivers high-quality medical care to the local community at 375 MOUNT PLEASANT AVE.

Dr. Lopes is affiliated with Summit Medical Group Pa and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

375 Mount Pleasant Ave

West Orange, NJ 070522750

Telephone 9737317707

Fax 9732322301

Associated Practice Facility / Clinic

🏢 Diagnostic & Clinical Cardiology, Pa Facility NPI 1760481493

Medicare Profile & Education

Medical School

Other

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in West Orange, NJ

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs -0.4 yrs vs City Avg

City Avg: 27.4 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

9 Specialists

Practicing in West Orange, NJ (815 Statewide)

Telehealth Adoption Rate

22.2% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

81.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lopes (27 Years) 27 Yrs

West Orange Specialty Average (27.4 Years) 27.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$412.00	$182.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	42	42	$274.00	$122.29
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	38	$277.37	$139.61
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	34	18	$179.00	$83.17
49650 Repair of groin hernia using an endoscope	32	32	$2836.13	$355.91
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	30	29	$497.00	$183.19
36415 Insertion of needle into vein for collection of blood sample	29	28	$15.00	$8.65
47562 Removal of gallbladder using an endoscope	26	26	$3767.73	$445.06
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	17	$336.00	$138.07
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	18	18	$32.00	$7.61
49505 Repair of groin hernia (5 years or older)	18	18	$2968.00	$393.50
80053 Blood test, comprehensive group of blood chemicals	17	17	$40.00	$10.35
99213 Established patient office or other outpatient visit, typically 15 minutes	17	16	$188.00	$99.84
85610 Blood test, clotting time	14	14	$17.00	$4.20
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$116.00	$62.26
85730 Coagulation assessment blood test, plasma or whole blood	12	12	$25.00	$5.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	87	43	$179.00	$86.48
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	79	79	$412.00	$186.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	48	$276.23	$143.27
36415 Insertion of needle into vein for collection of blood sample	43	37	$15.00	$8.40
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	37	36	$497.00	$186.23
47562 Removal of gallbladder using an endoscope	33	33	$3784.27	$473.02
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	25	16	$256.00	$130.05
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	24	22	$336.00	$142.20
80053 Blood test, comprehensive group of blood chemicals	20	20	$40.00	$10.35
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	19	19	$32.00	$7.61
49650 Repair of groin hernia using an endoscope	12	12	$2800.33	$409.08
49594 Initial repair of entrapped hernia of abdomen, 3-10 cm in length	12	12	$4036.17	$376.57
49505 Repair of groin hernia (5 years or older)	11	11	$2968.00	$540.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	106	43	$179.00	$77.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	58	58	$412.00	$188.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	53	36	$274.00	$144.64
36415 Insertion of needle into vein for collection of blood sample	47	35	$15.00	$2.96
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	38	35	$336.00	$143.04
80053 Blood test, comprehensive group of blood chemicals	23	19	$40.00	$10.45
99213 Established patient office or other outpatient visit, typically 15 minutes	21	21	$188.00	$102.59
47562 Removal of gallbladder using an endoscope	19	19	$4092.84	$617.37
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	18	16	$32.00	$7.70
99238 Hospital discharge day management, 30 minutes or less	14	11	$181.00	$79.04
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	13	$497.00	$215.33
44120 Partial removal of small bowel	12	11	$7013.92	$738.41
80048 Blood test, basic group of blood chemicals (calcium, total)	11	11	$35.00	$8.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	131	68	$179.00	$78.76
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	51	48	$336.00	$149.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	43	43	$412.00	$189.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	34	31	$274.00	$147.38
36415 Insertion of needle into vein for collection of blood sample	30	27	$15.00	$3.00
47562 Removal of gallbladder using an endoscope	21	21	$6451.33	$488.46
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	17	$497.00	$219.42
80053 Blood test, comprehensive group of blood chemicals	16	15	$40.00	$10.56
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	15	14	$32.00	$7.77
99213 Established patient office or other outpatient visit, typically 15 minutes	13	13	$188.00	$96.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	77	33	$219.86	$80.27
99213 Established patient office or other outpatient visit, typically 15 minutes	22	17	$230.55	$85.09
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	21	$336.00	$153.53
47562 Removal of gallbladder using an endoscope	19	19	$7650.42	$401.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	83	43	$300.00	$78.99
99213 Established patient office or other outpatient visit, typically 15 minutes	51	32	$240.00	$83.08
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	44	44	$345.00	$120.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	24	$710.00	$219.66
99284 Emergency department visit with moderate level of medical decision making	21	21	$1246.19	$125.85
47562 Removal of gallbladder using an endoscope	15	15	$11516.40	$434.43
49560 Repair of incisional or abdominal hernia	12	12	$8956.03	$506.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	53	30	$300.00	$78.45
99213 Established patient office or other outpatient visit, typically 15 minutes	49	35	$240.00	$80.83
99284 Emergency department visit with moderate level of medical decision making	30	28	$1020.00	$124.47
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	29	29	$345.00	$115.44
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	27	25	$710.00	$218.55
49560 Repair of incisional or abdominal hernia	24	22	$7279.76	$500.85
47562 Removal of gallbladder using an endoscope	16	16	$7250.85	$287.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	50	31	$240.00	$80.81
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	43	43	$345.70	$118.76
47562 Removal of gallbladder using an endoscope	25	25	$8191.80	$407.35
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	21	21	$710.00	$218.46
99284 Emergency department visit with moderate level of medical decision making	16	15	$1020.00	$124.59
49560 Repair of incisional or abdominal hernia	15	15	$6724.67	$292.25

Medical Specialties & State Licenses

CMS Verified: 2020-05-15

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NJ 25MA07899500

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0089931 (NJ)

Hospital & Practice Group Affiliations

Summit Medical Group Pa

1 Diamond Hill Rd, Berkeley Heights, NJ 079222104

Phone: 9082734300

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners

Dr. Derek Lim , DO

Surgery

NPI 1033567383

Doctor of Osteopathic Medicine (D.O.)

Dr. Zem Walk , MD

Obstetrics & Gynecology - Gynecology

NPI 1043310907

Doctor of Medicine (M.D.)

Dr. Stephen Crane , MD

Obstetrics & Gynecology

NPI 1073613998

Doctor of Medicine (M.D.)

Dr. Daniel Sansobrino , MD

Obstetrics & Gynecology

NPI 1174726491

Doctor of Medicine (M.D.)

Dr. Neil Russo , MD

Obstetrics & Gynecology

NPI 1235290966

Doctor of Medicine (M.D.)

Dr. Danielle Calvo , MD

Obstetrics & Gynecology

NPI 1356909444

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location May 15, 2020

Registered at 375 MOUNT PLEASANT AVE, WEST ORANGE, NJ 070522750 (Tel: 9737317707)

📍

Updated Business Mailing Address May 15, 2020

Registered at 375 MOUNT PLEASANT AVE, WEST ORANGE, NJ 070522750 (Tel: 9737317707)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 15, 2020

Surgery (License #25MA07899500 in NJ)

✅

NPI Profile Active February 15, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location February 15, 2008

Registered at 155 MORRIS AVE, SECOND FLOOR, SPRINGFIELD, NJ 070811225 (Tel: 9732322300)

📍

Updated Business Mailing Address February 15, 2008

Registered at 155 MORRIS AVE, SECOND FLOOR, SPRINGFIELD, NJ 070811225 (Tel: 9732322300)

👤

Provider Name / Credentials Updated February 15, 2008

Recorded as JOAO LOPES, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2008

Surgery

🟢

Initial NPI Registration & Enumeration May 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043268378

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 05, 2006

Last Update: May 15, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

375 Mount Pleasant Ave

West Orange, NJ 070522750

Phone: 9737317707

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.