Individual provider Active NPI

Rafael A Perez, M.D.

  • Pediatrics Physician
  • Aguas Buenas, PR
National Provider Identifier
1023175783
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
7225 Issued in PR
Practice address
48 Calle Rafael Lasa
Aguas Buenas, PR 00703-3321
Phone
(787) 732-3577
Fax
(787) 732-3577
NPI assigned
Jan 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 7225 PR Primary

Addresses

Primary practice location

48 Calle Rafael Lasa
Aguas Buenas, PR 00703-3321

Mailing address

PO Box 1212
Aguas Buenas, PR 00703-1212
Phone (787) 732-3577

Other identifiers 6

IdentifierTypeStateIssuer
81132PEOtherPRTRIPLE SSS
PE1691OtherPRPALIC
203244OtherPRPREFERED HEALTH
9270059OtherPRHUMANA
3869OtherPRINTERNATIONAL MEDICAL CAR
67356OtherPRCRUZ AZUL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20150714000890 PR Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1456664937

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7225PRMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023175783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1212",
            "city": "AGUAS BUENAS",
            "state": "PR",
            "postal_code": "007031212",
            "telephone_number": "787-732-3577",
            "fax_number": "787-732-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CALLE RAFAEL LASA",
            "city": "AGUAS BUENAS",
            "state": "PR",
            "postal_code": "007033321",
            "telephone_number": "787-732-3577",
            "fax_number": "787-732-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "RAFAEL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "7225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE SSS",
            "identifier": "81132PE",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALIC",
            "identifier": "PE1691",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERED HEALTH",
            "identifier": "203244",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "9270059",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL MEDICAL CAR",
            "identifier": "3869",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "67356",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguas Buenas, PR

Sources for this page

Verify at the official NPI Registry.