Active NPI
Phil Perez
- Specialist
- Buffalo, NY
National Provider Identifier
1104019991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 2107 Spruce Street
North Collins
Buffalo, NY 14111 - Phone
- (716) 337-3706
- Fax
- (716) 337-2723
- NPI assigned
- Aug 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
2107 Spruce Street
North Collins
Buffalo, NY 14111
Mailing address
254 Franklin St
Lake Shore Behavorial Health
Buffalo, NY 14202-1954
Phone (716) 842-0440
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bestself Behavioral Health, Inc. | Past | Accepting new patients |
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Orchard Park, NY
- NPI 1891907507
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187913600000",
"number": "1104019991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 FRANKLIN ST",
"address_2": "LAKE SHORE BEHAVORIAL HEALTH",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142021954",
"telephone_number": "716-842-0440",
"fax_number": "716-842-4069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2107 SPRUCE STREET",
"address_2": "NORTH COLLINS",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14111",
"telephone_number": "716-337-3706",
"fax_number": "716-337-2723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "PHIL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-24",
"last_updated": "2007-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.