Individual provider Active NPI

Sara Perez, PA

  • Surgical Physician Assistant
  • Richmond, VA
National Provider Identifier
1073004255
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110006207 Issued in VA
Practice address
417 N 11TH St
Richmond, VA 23298
Phone
(804) 828-7748
Fax
(804) 827-0285
NPI assigned
May 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110006207 VA Primary

Addresses

Primary practice location

417 N 11TH St
Richmond, VA 23298

Mailing address

PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100

Other practice location 1

2035 Waterside Rd Ste 100
Prince George, VA 23875-1265
Phone (804) 957-6287

Other practice location 2

1250 E Marshall St
Richmond, VA 23298-5051
Phone (804) 828-7748

Other practice location 3

11958 W Broad St
Henrico, VA 23233-1007
Phone (804) 360-4669

Other practice location 4

9109 Stony Point Dr
Richmond, VA 23235-1979
Phone (804) 827-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210323002195 NC Practitioner - Physician Assistant 7618217605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

Charlotte, NC 28203
Phone (704) 362-5391

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 362-1945

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 362-1945

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 362-5391

433 McAlister Rd
Lincolnton, NC 28092-4147
Phone (704) 362-1945

724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 612-4955

920 Church St N
Concord, NC 28025-2927
Phone (704) 334-7800

Hospital & facility affiliations

  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Radiology P a CurrentSince Mar 17, 2021 Accepting new patients

Locations

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

12335 N Community House Rd
Ste B
Charlotte, NC 28277

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

Interoperability endpoints

  • Direct secure messaging: sperez429690@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1073004255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N 11TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23298",
            "telephone_number": "804-828-7748",
            "fax_number": "804-827-0285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Waterside Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Prince George",
            "state": "VA",
            "postal_code": "238751265",
            "country_code": "US",
            "telephone_number": "804-957-6287",
            "fax_number": "804-827-0285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-7748",
            "fax_number": "804-827-0285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11958 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Henrico",
            "state": "VA",
            "postal_code": "232331007",
            "country_code": "US",
            "telephone_number": "804-360-4669",
            "fax_number": "804-827-0285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9109 Stony Point Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232351979",
            "country_code": "US",
            "telephone_number": "804-827-8000",
            "fax_number": "804-827-0285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "SARA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110006207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.