Individual provider Active NPI

Elizabeth Masindet Perera, MD

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1023794237
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
90250 Issued in SC
Practice address
169 Ashley Ave RM 202
Charleston, SC 29425-8905
Phone
(843) 792-2575
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 90250 SC Primary

Addresses

Primary practice location

169 Ashley Ave RM 202
Charleston, SC 29425-8905

Mailing address

169 Ashley Ave RM 202
Charleston, SC 29425-8905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240227003542 SC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1153766332

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Carolina School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13000 Deerfield Pkwy
Suite 100
Alpharetta, GA 30004-6118

13000 Deerfield Pkwy
Suite 100
Alpharetta, GA 30004-8965

169 Ashley Ave
202 Main Hospital
Charleston, SC 29425-0333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90250SCMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1023794237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERERA",
        "first_name": "ELIZABETH",
        "middle_name": "MASINDET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "90250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.