Individual provider Active NPI

Dolores Perez, M.D.

  • Specialist
  • Bronx, NY
National Provider Identifier
1003856642
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
200798 Issued in NY
Practice address
313 Revere Ave
Bronx, NY 10465-3013
Phone
(212) 888-8690
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 200798 NY Primary

Addresses

Primary practice location

313 Revere Ave
Bronx, NY 10465-3013

Mailing address

313 Revere Ave
Bronx, NY 10465-3013
Phone (212) 888-8690

Other identifiers 1

IdentifierTypeStateIssuer
02061058MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171108001436 NY Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 7214293257 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200798NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Hospital Yonkers Current Accepting new patients
St.Vincent' Hospital Westchester Psych CurrentSince Sep 13, 2017 Accepting new patients
St Josephs Hospital Yonkers CurrentSince Sep 13, 2017 Accepting new patients

Locations

275 North St
Harrison, NY 10528
Phone (914) 925-5211

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: dperez680871@nychhc.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1003856642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 REVERE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653013",
            "telephone_number": "212-888-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 REVERE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653013",
            "telephone_number": "212-888-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "DOLORES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "200798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02061058",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.