Individual provider Active NPI

Jose A Perez, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1104991561
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A20957 Issued in CA
Practice address
3500 Whittier Blvd BLDG Suite107
Los Angeles, CA 90023-1746
Phone
(323) 604-0260
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A20957 CA Primary

Addresses

Primary practice location

3500 Whittier Blvd BLDG Suite107
Los Angeles, CA 90023-1746

Mailing address

3500 Whittier Blvd BLDG Suite107
Los Angeles, CA 90023-1746
Phone (323) 604-0260

Other identifiers 2

IdentifierTypeStateIssuer
00A209570MedicaidCA
05D1013669OtherCACLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050831000937 CA Practitioner - Family Practice 4587695929 Receives reassigned benefits from 3 practitioners
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1962
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3500 Whittier Blvd
Suite 107
Los Angeles, CA 90023-1746
Phone (323) 604-0260

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20957CAMDProfessional Counselor
A20957CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jose a. Perez, MD, Inc Family Medicine PastSince Feb 15, 2003 Accepting new patients
Jose a Perez MD Family Medicine PastSince Aug 25, 2005 Accepting new patients
Isaias de Guzman Paja Jr. MD Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1104991561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 WHITTIER BLVD BLDG SUITE107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231746",
            "telephone_number": "323-604-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 WHITTIER BLVD BLDG SUITE107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900231746",
            "telephone_number": "323-604-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JOSE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A20957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A209570",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1013669",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.