Sujelis Perez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00314200 Issued in NJ

Practice address

347 Mount Pleasant Ave
Suite 103
West Orange, NJ 07052-2744

Phone

(973) 571-2121

Fax

(973) 498-0569

NPI assigned

Aug 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Dermatology LLCGroup PAC ID 5395703573, 46 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Clark Dermatology LLC

  • Dermatology Physician
  • Clark, NJ
  • NPI 1851562425
  Medicare reassignment Care Compare group
• Jay D Geller MD PC

  • Dermatology Physician
  • Chester, NJ
  • NPI 1629197819
  Medicare reassignment
• Schweiger Dermatology, PC

  • Dermatology Physician
  • Elmer, NJ
  • NPI 1104229392
  NPD (past)
• The Dermatology Group

  • Dermatology Physician
  • West Orange, NJ
  • NPI 1962428474
  NPD (past)
• Clark Dermatology, LLC

  • Dermatology Physician
  • Staten Island, NY
  • NPI 1417316274
  NPD (past)

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

{
    "created_epoch": "1377388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1104250307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079300399",
            "telephone_number": "973-571-2121",
            "fax_number": "973-498-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 MOUNT PLEASANT AVE",
            "address_2": "SUITE 103",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522744",
            "telephone_number": "973-571-2121",
            "fax_number": "973-498-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "SUJELIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-25",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00314200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Pensado Sendon, LPC
• Amy Pento, MA,CCCA
• Alexander Perelman, D.O.
• Augustine Perez, OPHTHALMIC DISPENSER
• Katherine Perez
• Perfect Physical Therapy LLC
• Periodontics and Implantology Associates, P.C.
• Donald Bret Perlman, M.D.
• Perri Savino & Ketz LLC
• Alexa Paige Perrone, PT, DPT

• Physician Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.