Active NPI
Timothy W. Perez, M.D
- Surgery Physician
- Albuquerque, NM
National Provider Identifier
1093729006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 93-126
- Practice address
- 715 Dr Martin Luther King NE
Ste 301
Albuquerque, NM 87102-2534 - Phone
- (505) 727-7090
- Fax
- (505) 727-7099
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 93-126 | NM | |
| Surgery Physician | 208600000X | 93-126 | NM | Primary |
Addresses
Primary practice location
715 Dr Martin Luther King NE
Ste 301
Albuquerque, NM 87102-2534
Mailing address
715 Dr Martin Luther King NE
Ste 301
Albuquerque, NM 87102-2534
Phone (505) 727-7090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16400844 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albuquerque Surgical Consultants PC | Surgery | Past | Accepting new patients |
| Lovelace Health System, Inc. | Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Surgery Physician
- Albuquerque, NM
- NPI 1750442133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455580800000",
"number": "1093729006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 DR MARTIN LUTHER KING NE",
"address_2": "STE 301",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871022534",
"telephone_number": "505-727-7090",
"fax_number": "505-727-7099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 DR MARTIN LUTHER KING NE",
"address_2": "STE 301",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871022534",
"telephone_number": "505-727-7090",
"fax_number": "505-727-7099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "TIMOTHY",
"middle_name": "W.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2016-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "93-126",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NM",
"license": "93-126",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16400844",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.